Individual
STACEY CHILDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1210 ALDERSGATE RD, LITTLE ROCK, AR 72205-6606
(501) 574-3053
Mailing address
1210 ALDERSGATE RD, LITTLE ROCK, AR 72205-6606
(501) 574-3053
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19879
AR
Other
Enumeration date
10/15/2015
Last updated
11/23/2020
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