| Doctor Name: | MRS. MARY PATRICE BANTON |
| NPI Number: | 1225233034 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED., LPC, LCSW |
| License Number: | 002431 |
| Business Practice Address: | 330 N Gore Ave Webster Groves, MO - 631191600 |
| Business Phone Number: | 3146194729 |
| Business Fax Number: | 3149194850 |
| Mailing Address: | 809 Guenevere Dr, BALLWIN |
| State: | MO |
| Postal Code: | 630113526 |
| Phone Number: | 3146194729 |
| Fax Number: | 3149194850 |
| NPI Enumeration Date: | 06/20/2007 |
| NPI Last Update Date: | 12/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 002431 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |