Organization
GREEN, MAXVILLE, AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE ALLEN MAXVILLE JR. PHD BCBA-D (OWNER)
(573) 864-9743
Entity
Organization
Contact information
Practice address
2743 RUSSELL BLVD, SAINT LOUIS, MO 63104-2137
(573) 864-9743
Mailing address
2743 RUSSELL BLVD, SAINT LOUIS, MO 63104-2137
(573) 864-9743
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
MO
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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