Individual
MS. EBONEE MONIQUE LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4444 FOREST PARK AVE, STE 2600, SAINT LOUIS, MO 63108-2212
(314) 286-1700
(314) 286-1777
Mailing address
660 S EUCLID AVE, CB 8134, SAINT LOUIS, MO 63110-1010
(314) 286-1700
(314) 286-1730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2010035826
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499417301
—
MO
Enumeration date
09/14/2012
Last updated
01/09/2023
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