Healthcare Provider Details

I. General information

NPI: 1336354299
Provider Name (Legal Business Name): KATHRYN E ASBURY BCBA, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2143 BREDELL AVE
SAINT LOUIS MO
63143-1114
US

IV. Provider business mailing address

2143 BREDELL AVE
SAINT LOUIS MO
63143-1114
US

V. Phone/Fax

Practice location:
  • Phone: 314-781-9316
  • Fax:
Mailing address:
  • Phone: 314-781-9316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13960
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: