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General NPI Number Information
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NPI Number | 1568078160
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Entity Type | Individual
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Provider Name | CORI MCINTIRE BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 385 W VETERANS MEMORIAL PKWY
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City | WARRENTON
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State | MO
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Zip | 63383-1066
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Country | US
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Telephone | 636-456-6984
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Fax |
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Provider Business Mailing Address
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Address Line | 91 TISBURY CT
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City | O FALLON
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State | MO
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Zip | 63366-1576
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Country | US
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Telephone | 304-482-8809
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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 | 2018008853
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License Number State | MO
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