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Individual
MRS. BECKY LEE DOUGLAS
Active
Individual
MRS. BECKY LEE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2011014803
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2011014803
MO
Other
Enumeration date
07/01/2011
Last updated
07/21/2011
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