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Individual

JENNY HARTGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12400 OLIVE BLVD, SUITE 340, ST. LOUIS, MO 63141
(314) 303-0849
(618) 218-9219
Mailing address
P.O. BOX 1092, COLUMBIA, IL 62236

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
2017003939
MO

Other

Enumeration date
03/02/2017
Last updated
03/02/2017
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