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Individual

MRS. AMANDA FOULKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10176 CORPORATE SQUARE DR, SAINT LOUIS, MO 63132-2924
(314) 395-9375
(314) 395-9382
Mailing address
10176 CORPORATE SQUARE DR, SAINT LOUIS, MO 63132-2924
(314) 395-9375
(314) 395-9382

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2015025108
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-15-17974
BCBA
01
2015025108
LBA
MO
Enumeration date
07/23/2015
Last updated
07/23/2015
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