Individual
ELIJAH MICHAEL AUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PLBA
Contact information
Practice address
1220 NE WINDSOR DR, LEES SUMMIT, MO 64086-5594
(573) 410-8176
Mailing address
1220 NE WINDSOR DR, LEES SUMMIT, MO 64086-5594
(573) 410-8176
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2026011574
MO
106S00000X
Behavior Technician
Primary
RBT-24-333896
—
Other
Enumeration date
02/23/2022
Last updated
03/24/2026
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