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General NPI Number Information
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NPI Number | 1841724606
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Entity Type | Individual
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Provider Name | LINDSEY FREIVOGEL M.S. ABA
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 2560 METRO BLVD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-2417
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Country | US
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Telephone | 314-715-3855
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Fax |
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Provider Business Mailing Address
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Address Line | 3873 BOTANICAL AVE APT F
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City | SAINT LOUIS
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State | MO
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Zip | 63110-4086
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Country | US
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Telephone | 618-698-3073
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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 | 2017004345
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License Number State | MO
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