Individual
JAMIE SUZANNE BRAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA, LABA
Contact information
Practice address
611 N FOUNTAIN ST, CAPE GIRARDEAU, MO 63701-7244
(573) 225-5828
Mailing address
1 UNIVERSITY PLZ, MAILSTOP 9450, CAPE GIRARDEAU, MO 63701-4710
(573) 225-5828
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2011024511
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011024511
STATE OF MISSOURI
MO
Enumeration date
01/02/2013
Last updated
01/02/2013
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