Individual
OLIVIA JOY TEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, BCBA, LBA
Contact information
Practice address
9374 OLIVE BLVD, SAINT LOUIS, MO 63132-3267
(314) 932-2402
Mailing address
9374 OLIVE BLVD, SAINT LOUIS, MO 63132-3267
(314) 932-2402
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2019004910
MO
Other
Enumeration date
04/04/2019
Last updated
04/10/2020
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