Individual
TASHA OLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2778 MALLARD CT, IMPERIAL, MO 63052-1436
(636) 376-7621
Mailing address
2778 MALLARD CT, IMPERIAL, MO 63052-1436
(636) 376-7621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2024014262
MO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/28/2020
Last updated
05/10/2024
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