| NPI | 1962976084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA YOST BRADFORD Owner 314-698-4266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2025-01-22 |