Individual
MARISSA JOY MCVICAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
330 N GORE AVE, SAINT LOUIS, MO 63119-1600
(314) 968-2060
Mailing address
11611 FRONTIER DR, SAINT LOUIS, MO 63146-4852
(314) 805-1777
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2019041190
MO
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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