Individual
ETHAN JOHN DULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9734 OLIVE BLVD, UNIT 101, SAINT LOUIS, MO 63132-3253
(314) 932-2402
(314) 666-9770
Mailing address
7500 SAN FELIPE ST STE 990, HOUSTON, TX 77063-1708
(281) 826-3382
(425) 491-7683
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
MO
Other
Enumeration date
03/23/2022
Last updated
10/13/2023
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