Individual
MS. LISA ANN FLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ABA
Contact information
Practice address
4444 FOREST PARK AVE, STE 2600, SAINT LOUIS, MO 63108-2212
(314) 286-1700
(314) 286-1777
Mailing address
PO BOX 60352, SAINT LOUIS, MO 63160-0352
(314) 286-1700
(314) 286-1777
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
2018008240
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
730052046
—
MO
Enumeration date
01/16/2018
Last updated
04/25/2024
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