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NPI Code Detail

MEDICARE: ELISE G AMO BCBA, LBA

MEDICARE:   ELISE G AMO  BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2023014031MO

General Provider Information

NPI Number : 1366281883
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISE G AMO BCBA, LBA
Provider Business Mailing Address
First Line : 3533 DUNN RD STE 210
Second Line :
City : FLORISSANT
State : MO
Zip : 63033-6761
Country : US
Telephone Number : 636-398-2510
Fax Number : 800-687-5070
Provider Business Practice Location Address
First Line : 3533 DUNN RD STE 210
Second Line :
City : FLORISSANT
State : MO
Zip : 63033-6761
Country : US
Telephone Number : 636-398-2510
Fax Number : 800-687-5070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2024
Last Update Date : 05/27/2026

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Directions to “ ELISE G AMO BCBA, LBA” Practice Location

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