Individual
THIAGO W OLIVEIRA MENDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 872-3345
Mailing address
601 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1317720
MO
Other
Enumeration date
11/06/2025
Last updated
11/06/2025
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