Individual
LUCAS ROBERT RAINWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2055 CRAIGSHIRE RD, SAINT LOUIS, MO 63146-4036
(314) 275-0506
Mailing address
1608 BREMEN AVE, GRANITE CITY, IL 62040-2309
(618) 979-8371
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-218740
MO
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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