Healthcare Provider Details
I. General information
NPI: 1659294114
Provider Name (Legal Business Name): ROCKET ABA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 CHASSELLE LN
SAINT LOUIS MO
63141-7334
US
IV. Provider business mailing address
301 CHASSELLE LN
SAINT LOUIS MO
63141-7334
US
V. Phone/Fax
- Phone: 816-204-0867
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMANTHA
OSGOOD
Title or Position: CHIEF OPERATING OFFICER
Credential: M.A., BCBA, LBA
Phone: 816-204-0867