Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 2018036833 | MO |
N | 106E00000X | Assistant Behavior Analyst | 2018036833 | MO |
NPI | 1164982054 |
---|---|
Provider Name | Anna Hastings |
First Address | Festus, MO 63028-4571 |
Second Address | Saint Louis, MO 63112-3312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2019 |
Last Update Date | 19/07/2020 |