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General NPI Number Information
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NPI Number | 1174008742
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Entity Type | Individual
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Provider Name | DR. VALENTINA PENALBA
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Gender | Female
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Dates
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Enumeration Date | 09/30/2018
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Last Update Date | 09/30/2018
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Provider Practice Location Address
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Address Line | 7750 CLAYTON RD STE 204
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1342
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Country | US
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Telephone | 314-606-1129
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Fax |
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Provider Business Mailing Address
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Address Line | 10612 BALLANTRAE DR
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2830
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Country | US
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Telephone | 314-606-1129
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2015010341
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License Number State | MO
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