Individual
ANITA BAZILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6195 WASHINGTON BLVD, SAINT LOUIS, MO 63112-1207
(314) 805-0941
Mailing address
12845 MEADOWDALE DR, SAINT LOUIS, MO 63138-1544
(314) 805-0941
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2007002473
MO
Other
Enumeration date
10/10/2013
Last updated
10/12/2013
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