NPI 1053972380 · live from the CMS NPI Registry
Elise Marie Bagley, BCBA
Behavior Analyst in Arnold, MO. National Provider Identifier 1053972380, active.
NPI record
| NPI | 1053972380 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 4051 Jeffco Blvd Ste 3, Arnold, MO 63010 |
| Practice phone | 163-622-3007 |
| Mailing address | 447 Thurwell St, Herculaneum, MO 63048 |
| Enumerated | June 26, 2019 |
| Last updated | May 6, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 2021019217 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.