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General NPI Number Information
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NPI Number | 1245166479
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Entity Type | Individual
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Provider Name | STACI ARCHIBALD M.S., PLBA
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Gender | Female
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 14 SOCCER PARK RD
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City | FENTON
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State | MO
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Zip | 63026-2564
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Country | US
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Telephone | 636-485-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 312 COUNTRYSHIRE DR
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City | LAKE SAINT LOUIS
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State | MO
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Zip | 63367-5820
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Country | US
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Telephone | 636-485-5556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | E173177007
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License Number State | MO
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