Organization
GERIATRIC PSYCHOTHERAPY SERVICES GINA BAX, MSW, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GINA NICOLE BAX LCSW (CLINICAL SOCIAL WORKER)
(636) 577-4607
Entity
Organization
Contact information
Practice address
261 BLESS US DR E, WENTZVILLE, MO 63385-2227
(636) 577-4607
Mailing address
261 BLESS US DR E, WENTZVILLE, MO 63385-2227
(636) 577-4607
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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