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General NPI Number Information
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NPI Number | 1699943068
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Entity Type | Organization
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Legal Business Name | BARBARA C BURTON
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 1023 EXECUTIVE PARKWAY DR SUITE 8
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6323
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Country | US
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Telephone | 314-878-8855
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Fax | 314-434-2331
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Provider Business Mailing Address
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Address Line | 1023 EXECUTIVE PARKWAY DR SUITE 8
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6323
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Country | US
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Telephone | 314-878-8855
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Fax | 314-434-2331
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. BARBARA CIESLAK BURTON
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Credential | LCSW
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Telephone | 314-878-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0001346
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License Number State | MO
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