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General NPI Number Information
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NPI Number | 1215487590
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Entity Type | Individual
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Provider Name | MARIE BONNER-HORON
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Gender | Female
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 500 HUBER PARK CT STE 203
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City | WELDON SPRING
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State | MO
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Zip | 63304-8683
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Country | US
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Telephone | 636-344-0580
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Fax | 636-206-2486
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Provider Business Mailing Address
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Address Line | 3115 S GRAND BLVD STE 450
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City | SAINT LOUIS
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State | MO
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Zip | 63118-1045
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Country | US
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Telephone | 314-577-0444
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2016032550
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License Number State | MO
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