Individual
SAMANTHA WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9544 MANCHESTER RD, SAINT LOUIS, MO 63119-1313
(573) 203-3699
Mailing address
2524 BLACK WATER DR, SAINT LOUIS, MO 63129-5410
(314) 583-9890
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2025045217
MO
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/26/2025
Last updated
03/13/2026
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