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SIMONE LILA LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S, BCBA

Contact information

Practice address
4721 S. CLIFF AVE SUITE 103, SUITE 103, INDEPENDENCE, MO 64055
(816) 368-8120
(800) 687-5070
Mailing address
4721 S. CLIFF AVE SUITE 103, SUITE 103, INDEPENDENCE, MO 64055
(816) 368-8120
(800) 687-5070

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43267
OH
106S00000X
Behavior Technician
RBT-18-62827
OH

Other

Enumeration date
09/25/2018
Last updated
09/14/2020
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