Individual
SAMANTHA RAE PARKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
601 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6060
Mailing address
601 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-101262
MO
Other
Enumeration date
08/30/2020
Last updated
08/30/2020
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