Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003004557 |
---|---|
Provider Name | Mr. Eric Scott Baile |
First Address | Saint Louis, MO 63141-8704 |
Second Address | Saint Louis, MO 63141-8704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 10/10/2007 |