Individual
JANET MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 364-4193
Mailing address
10318 MONARCH DR, SAINT LOUIS, MO 63136-5610
(314) 240-4046
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-144902
MO
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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