Individual
CALLI MICLANE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 271-5240
Mailing address
2150 BELLERIDGE PIKE, CAPE GIRARDEAU, MO 63701-1865
(573) 979-1187
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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