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Individual

DR. DALE ALLEN MAXVILLE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD BCBA-D

Contact information

Practice address
2743 RUSSELL BLVD, SAINT LOUIS, MO 63104-2137
(573) 864-9743
(573) 874-1723
Mailing address
2743 RUSSELL BLVD, SAINT LOUIS, MO 63104-2137
(573) 864-9743
(573) 874-1723

Taxonomy

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

Other

Enumeration date
12/11/2006
Last updated
06/21/2011
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