Individual
MITON SHATOREY CLAYBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3541 SALENA ST, SAINT LOUIS, MO 63118-4024
(314) 910-2722
Mailing address
3541 SALENA ST, SAINT LOUIS, MO 63118-4024
(314) 910-2722
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MO
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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