| Organization Name: | LET'S TALK TEEN CLINIC INC. |
| NPI Number: | 1164860375 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STAISY YOUNG (NURSE PRACTITIONER) |
| Mailing Address: | 119 Church Street Suite 131 Ferguson |
| State: | MO US |
| Postal Code: | 63135 |
| Phone Number: | 3144942584 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2013 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 2002031370 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |