Individual
MRS. MARY PATRICE BANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, LCSW
Contact information
Practice address
330 N GORE AVE, WEBSTER GROVES, MO 63119-1600
(314) 619-4729
(314) 919-4850
Mailing address
809 GUENEVERE DR, BALLWIN, MO 63011-3526
(314) 619-4729
(314) 919-4850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001291
MO
1041C0700X
Clinical Social Worker
002431
MO
Other
Enumeration date
06/20/2007
Last updated
12/23/2010
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