Individual
ANGELA T HERNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599
(314) 989-8448
Mailing address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599
(314) 989-8448
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
2022031786
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490101230
—
MO
Enumeration date
06/19/2008
Last updated
02/09/2023
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