Individual
MR. MATTHEW PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
4000 HEALY CT, SAINT LOUIS, MO 63123-7743
(913) 909-7397
Mailing address
4000 HEALY CT, SAINT LOUIS, MO 63123-7743
(913) 909-7397
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2018045061
MO
106E00000X
Assistant Behavior Analyst
2017024061
MO
Other
Enumeration date
07/17/2017
Last updated
01/07/2019
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