Individual
PARKER RYAN LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
518 SELMA AVE, SAINT LOUIS, MO 63119-4142
(314) 910-8371
Mailing address
518 SELMA AVE, SAINT LOUIS, MO 63119-4142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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