Individual
ASHLEY SUSAN DEIMUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
910 SPRINGFIELD RD, WILLOW SPRINGS, MO 65793-1036
(573) 701-3312
Mailing address
PO BOX 683, WILLOW SPRINGS, MO 65793-0683
(573) 701-3312
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42224
MO
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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