Individual
MYA NICOLE ST LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 N 15TH ST, EAST ORANGE, NJ 07017-5271
(862) 576-4968
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(862) 567-4986
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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