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General NPI Number Information
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NPI Number | 1740875632
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Entity Type | Individual
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Provider Name | JENNIFER D FREUND PLBA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 330 N GORE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63119-1600
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Country | US
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Telephone | 314-341-7882
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Fax |
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Provider Business Mailing Address
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Address Line | 367 BECKLEY PL
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City | SAINT CHARLES
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State | MO
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Zip | 63304-1030
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Country | US
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Telephone | 636-577-7020
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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 | 2020040897
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License Number State | MO
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