Individual
PENNIE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7566 CORNELL AVE, SAINT LOUIS, MO 63130-2813
(314) 706-1842
Mailing address
7566 CORNELL AVE, SAINT LOUIS, MO 63130-2813
(314) 706-1842
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MO
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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