Individual
KALLIE FEDERHOFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9544 MANCHESTER RD, SAINT LOUIS, MO 63119-1313
(573) 203-3699
Mailing address
3621 MARION LN, LAS CRUCES, NM 88012-7579
(575) 520-6074
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2026010665
MO
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2025
Last updated
05/29/2026
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