Individual
MICHAEL ANTHONY RUBERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10542 COPPERFIELD DR, SAINT LOUIS, MO 63123-5002
(314) 852-4530
Mailing address
10542 COPPERFIELD DR, SAINT LOUIS, MO 63123-5002
(314) 852-4530
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001531
MO
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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