Individual
MS. REBECCA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1333 WEST LOCKWOOD, SAINT LOUIS, MO 63122-4817
(800) 780-6545
(888) 507-4453
Mailing address
112 HOLLY DRIVE, SAINT LOUIS, MO 63119-4639
(314) 749-7768
(888) 507-4453
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2011007859
MO
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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