Individual
MS. MELANIE BANNISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
3909A MAGNOLIA AVE, SAINT LOUIS, MO 63110-4026
(314) 229-6779
(314) 773-6073
Mailing address
3909 MAGNOLIA AVE, SAINT LOUIS, MO 63110-4026
(314) 229-6779
(314) 229-6779
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002633
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497945006
—
MO
Enumeration date
03/05/2007
Last updated
11/02/2009
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