Individual
MRS. REBECCA JEAN TAVERNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
333 OZARK TRAIL DR STE 50, ELLISVILLE, MO 63011-2185
(816) 608-1500
(800) 687-5070
Mailing address
4721 S CLIFF AVE STE 103, INDEPENDENCE, MO 64055-6969
(816) 608-1958
(800) 687-5070
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2022005504
MO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/09/2018
Last updated
04/01/2022
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