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General NPI Number Information
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NPI Number | 1588360721
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Entity Type | Individual
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Provider Name | DANIELLE SULTANA TOLMAIS NONE
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Gender | Female
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 7522 BIG BEND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-2104
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Country | US
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Telephone | 314-532-0544
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Fax | 573-874-1723
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Provider Business Mailing Address
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Address Line | 7522 BIG BEND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-2104
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Country | US
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Telephone | 314-532-0544
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Fax | 573-874-1723
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 00017419
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2023040658
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License Number State | MO
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