Individual
LACEY RUBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(314) 657-9003
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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