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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA CHASE HAMBURG (CO-OWNER)
(417) 268-8992
Entity
Organization

Contact information

Practice address
208 SHADY ACRES CIRCLE, NIXA, MO 65714
(417) 597-3828
Mailing address
208 SHADY ACRES CIR, NIXA, MO 65714-6709

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/16/2026
Last updated
03/26/2026
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