Individual
MRS. SALLY LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
910 W 14TH ST STE 230, WASHINGTON, MO 63090-7003
(573) 480-0440
Mailing address
910 W 14TH ST STE 230, WASHINGTON, MO 63090-7003
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2016035609
MO
Other
Enumeration date
02/06/2017
Last updated
01/22/2025
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