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Individual

LEZLEY BANTOLINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
16 MUNICIPAL DR STE D, ARNOLD, MO 63010-1043
(636) 333-2641
(573) 803-1405
Mailing address
16 MUNICIPAL DR STE D, ARNOLD, MO 63010-1043
(636) 333-2641
(573) 803-1405

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MO

Other

Enumeration date
09/19/2020
Last updated
09/19/2020
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