Individual
SOPHIA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9544 MANCHESTER RD, SAINT LOUIS, MO 63119-1313
(314) 270-2151
Mailing address
9544 MANCHESTER RD, SAINT LOUIS, MO 63119-1313
(314) 270-2151
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2025017228
MO
106S00000X
Behavior Technician
Primary
RBT-24-0474-832946
MO
Other
Enumeration date
10/23/2024
Last updated
05/29/2026
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