NPI 1770943284 · live from the CMS NPI Registry
Jennifer Bettale, BCBA
Behavior Analyst in O Fallon, MO. National Provider Identifier 1770943284, active.
NPI record
| NPI | 1770943284 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 105 Sheriff Dierker Ct, O Fallon, MO 63366 |
| Practice phone | 636-978-7785 |
| Mailing address | 7203 Dartmouth Ave, 2e, Saint Louis, MO 63130 |
| Enumerated | February 25, 2016 |
| Last updated | February 25, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 1-15-19852 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.