Individual
MR. GARY WILLIAM BENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6126 TENNESSEE AVE, SAINT LOUIS, MO 63111-2323
(314) 832-1082
Mailing address
6126 TENNESSEE AVE, SAINT LOUIS, MO 63111-2323
(314) 832-1082
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2005016662
MO
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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