Doctor Name: | MR. GEORGE A BATES |
NPI Number: | 1013901818 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LCPC |
License Number: | |
Business Practice Address: | 8 Eagle Center O Fallon, IL - 622691947 |
Business Phone Number: | 6186241234 |
Business Fax Number: | 6186242027 |
Mailing Address: | 8 Eagle Ctr, O FALLON |
State: | IL |
Postal Code: | 622691947 |
Phone Number: | 6186241234 |
Fax Number: | 6186242027 |
NPI Enumeration Date: | 09/07/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |