Organization
SHAWNEE BEHAVIORAL CONSULTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA ANN RUZICKA M.S., BCBA (BOARD CERTIFIED BEHAVIOR ANALYST)
(618) 977-2773
Entity
Organization
Contact information
Practice address
224 BELDEN DR, EDWARDSVILLE, IL 62025-3178
(618) 977-2773
(312) 626-2429
Mailing address
7384 SHARP AVE, SAINT LOUIS, MO 63116-3040
(618) 977-2773
(312) 626-2429
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1084838
IL
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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