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Individual

MRS. THERESA AILEEN STROTHKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED., BCBA, LBA

Contact information

Practice address
1177 N WARSON RD, SAINT LOUIS, MO 63132-1810
(314) 569-2211
(314) 569-0778
Mailing address
1177 N WARSON RD, SAINT LOUIS, MO 63132-1810
(314) 569-2211
(314) 569-0778

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11211754
MO
222Q00000X
Developmental Therapist
11211754
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11211754
LICENSE
MO
Enumeration date
04/18/2013
Last updated
04/18/2013
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