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General NPI Number Information
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NPI Number | 1083553069
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Entity Type | Organization
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Legal Business Name | IJB THERAPY LLC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 5219 S KINGSHIGHWAY BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2924
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Country | US
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Telephone | 314-246-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 5219 S KINGSHIGHWAY BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2924
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Country | US
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Telephone | 314-246-0710
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | IRENA BARTNICK
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Credential | BARTNICK
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Telephone | 314-583-2321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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