Organization
INTERNATIONAL MOSAIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YUIMA MIZUTANI M.ED., NCC, LPC (OWNER)
(314) 498-4449
Entity
Organization
Contact information
Practice address
225 S MERAMEC AVE STE 203, SAINT LOUIS, MO 63105-3511
(314) 492-6296
Mailing address
5528 PERSHING AVE APT 405, SAINT LOUIS, MO 63112-1791
(314) 498-4449
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841771748
—
MO
Enumeration date
03/13/2019
Last updated
03/13/2019
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