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Individual

TAMICKA NELSON- BOBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12215 WINTERSET DR, BLACK JACK, MO 63033-7333
(314) 629-7281
Mailing address
12215 WINTERSET DR, BLACK JACK, MO 63033-7333
(314) 629-7281

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
146D00000X
Personal Emergency Response Attendant
171M00000X
Case Manager/Care Coordinator
171R00000X
Interpreter
176B00000X
Midwife
251E00000X
Home Health Agency
Primary
253Z00000X
In Home Supportive Care Agency
332U00000X
Home Delivered Meals
372600000X
Adult Companion
374U00000X
Home Health Aide
376K00000X
Nurse's Aide
385H00000X
Respite Care

Other

Enumeration date
08/13/2020
Last updated
08/13/2020
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