Individual
ASHLEY LARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
631 APPLECROSS CT, MANCHESTER, MO 63021-7721
(314) 706-1842
Mailing address
631 APPLECROSS CT, MANCHESTER, MO 63021-7721
(314) 706-1842
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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