Individual
JULIA VANDER WENDE ROSCOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, MA, BCBA
Contact information
Practice address
3730 S LINDBERGH BLVD # 246, SAINT LOUIS, MO 63127-1376
(314) 246-0587
Mailing address
3730 S LINDBERGH BLVD # 246, SAINT LOUIS, MO 63127-1376
(314) 246-0587
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-05-2421
BCBA CERTIFICATION NUMBERR
—
Enumeration date
08/26/2009
Last updated
05/30/2013
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