Provider Demographics
NPI:1407026057
Name:HESTER, MARY L
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:L
Last Name:HESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 ST. VINCENT AVE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1418
Mailing Address - Country:US
Mailing Address - Phone:314-773-5350
Mailing Address - Fax:314-773-5350
Practice Address - Street 1:3128 ST. VINCENT AVE
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1418
Practice Address - Country:US
Practice Address - Phone:314-773-5350
Practice Address - Fax:314-773-5350
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities