Individual
JESIKA WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14733 CLAYTON RD, BALLWIN, MO 63011-2660
(314) 339-7732
Mailing address
5149 CHELTENHAM RD, BLACK JACK, MO 63033-7424
(314) 386-4644
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2024039220
MO
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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