Healthcare Provider Details

I. General information

NPI: 1164982054
Provider Name (Legal Business Name): ANNA HASTINGS MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 07/19/2020
Certification Date: 07/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5356 VERNON AVE
SAINT LOUIS MO
63112-3312
US

IV. Provider business mailing address

1855 BURLEY RD
FESTUS MO
63028-4571
US

V. Phone/Fax

Practice location:
  • Phone: 314-368-9829
  • Fax:
Mailing address:
  • Phone: 573-315-6566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number2018036833
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2018036833
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: