Healthcare Provider Details

I. General information

NPI: 1093483109
Provider Name (Legal Business Name): WAYS OF PLAY COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 KISKER RD STE 100
SAINT PETERS MO
63304-0602
US

IV. Provider business mailing address

5377 STATE HWY N SUITE 365
COTTLEVILLE MO
63304
US

V. Phone/Fax

Practice location:
  • Phone: 636-344-0580
  • Fax: 636-206-2486
Mailing address:
  • Phone: 636-344-0580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIE BONNER-HORON
Title or Position: OWNER
Credential:
Phone: 618-292-5957