Individual
MICHELLE CHRISTINE LACKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7477 DELMAR BLVD, SAINT LOUIS, MO 63130-4065
(314) 410-9670
Mailing address
2288 AILESWOOD CT, SAINT LOUIS, MO 63129-3607
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-236538
—
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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