Organization
AUTISM & BEHAVIOR CONSULTANTS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER B NOWAK CCC-SLP/BCBA (OWNER/DIRECTOR)
(573) 714-6855
Entity
Organization
Contact information
Practice address
234 SOUTH DR., POPLAR BLUFF, MO 63901
(573) 714-6855
Mailing address
234 SOUTH DR., POPLAR BLUFF, MO 63901
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
20110000573
MO
103K00000X
Behavior Analyst
2011008959
MO
235Z00000X
Speech-Language Pathologist
2000174350
MO
235Z00000X
Speech-Language Pathologist
2006011487
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/13/2012
Last updated
12/07/2012
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