| Doctor Name: | MRS. MARY LYNN PALOMBO |
| NPI Number: | 1083708820 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | 004774 |
| Business Practice Address: | #1 Jefferson Barracks Drive St. Louis, MO - 63125 |
| Business Phone Number: | 3148946547 |
| Business Fax Number: | |
| Mailing Address: | 1945 Forest Haven Drive, IMPERIAL |
| State: | MO |
| Postal Code: | 63052 |
| Phone Number: | 3148946547 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 004774 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |