NPI 1902651201 · live from the CMS NPI Registry
Stacey Back
Behavior Analyst in Springfield, MO. National Provider Identifier 1902651201, active.
NPI record
| NPI | 1902651201 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 1721 W Elfindale St Ste B, Springfield, MO 65807 |
| Practice phone | 417-874-1906 |
| Mailing address | 2864 S Nettleton Ave, Springfield, MO 65807 |
| Enumerated | April 19, 2024 |
| Last updated | April 4, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.