Individual
MRS. AMANDA J KEHOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4817 BLACKHAWK DR, SAINT LOUIS, MO 63123-5703
(314) 845-3900
(314) 845-3901
Mailing address
4817 BLACKHAWK DR, SAINT LOUIS, MO 63123-5703
(314) 845-3900
(314) 845-3901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB258013
MO
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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