Individual
SYLVIA NISSENBOIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12401 OLIVE BLVD, SAINT LOUIS, MO 63141-5448
(314) 477-3144
Mailing address
10435 ARTHUR PL, SAINT LOUIS, MO 63131-2708
(314) 477-3144
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
730
MO
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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