Individual
LISA ANN LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA, LBA
Contact information
Practice address
650 OFFICE PKWY, CREVE COEUR, MO 63141-7103
(314) 838-1465
Mailing address
5821 THOLOZAN AVE, SAINT LOUIS, MO 63109-1437
(314) 201-0152
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2018015025
MO
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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