Individual
MS. MARY C. VANDERKLOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4941 ITASKA ST, SAINT LOUIS, MO 63109-2912
(314) 752-3962
Mailing address
4941 ITASKA ST, SAINT LOUIS, MO 63109-2912
(314) 752-3962
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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