Organization
CHRYSALIS BEHAVIOR SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE MARIE LITTLEBO BCBA (OWNER)
(618) 521-7177
Entity
Organization
Contact information
Practice address
13887 JEFFREY MINE ROAD, JOHNSTON CITY, IL 62951
(618) 521-7177
(314) 667-3167
Mailing address
13887 JEFFERY MINE RD, JOHNSTON CITY, IL 62951-2925
(618) 521-7177
(314) 667-3167
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-9714
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-14-9714
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
08/04/2017
Last updated
07/21/2022
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