Individual
JENNIFER BETTALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
105 SHERIFF DIERKER CT, O FALLON, MO 63366-2468
(636) 978-7785
Mailing address
7203 DARTMOUTH AVE, 2E, SAINT LOUIS, MO 63130-3007
(773) 272-5598
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19852
MO
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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