Healthcare Provider Details

I. General information

NPI: 1780558569
Provider Name (Legal Business Name): LESLIE HOTCHKISS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11872 WESTLINE INDUSTRIAL DR STE 100
SAINT LOUIS MO
63146-3331
US

IV. Provider business mailing address

4031 LOCKE AVE
BRIDGETON MO
63044-2036
US

V. Phone/Fax

Practice location:
  • Phone: 314-991-7944
  • Fax:
Mailing address:
  • Phone: 314-810-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-478690
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: