Individual
MADELINE SUZANNE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
11432 TESSON FERRY RD, SAINT LOUIS, MO 63123-6925
(217) 525-8332
Mailing address
11432 TESSON FERRY RD, SAINT LOUIS, MO 63123-6925
(217) 525-8332
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2018023465
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477019891
—
MO
Enumeration date
02/11/2019
Last updated
02/03/2023
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