| NPI | 1992456883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY WALEHWA Executive Director/Provider 314-884-1307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |