Dasiah Alexandria Bolden
Individual provider Active NPI Behavior Technician · Affton, MO
NPI 1245061241 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1245061241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-23-310906
- Practice address
- 96 Grasso PLZ
Affton, MO 63123-3108 - Phone
- (636) 398-2515
- Fax
- (800) 687-5070
- NPI assigned
- Aug 12, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Support Now, LLC | Current |
Accepting new patients |
Locations
4721 S Cliff Ave
Ste 103
Independence, MO 64055
Phone (816) 381-9090
96 Grasso Plz
Saint Louis, MO 63123
Phone (636) 398-2515
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-310906 | Yes |
Addresses
Primary practice location
96 Grasso PLZ
Affton, MO 63123-3108
Mailing address
4721 S Cliff Ave Ste 103
Independence, MO 64055-6969
Phone (816) 608-1958
Other providers in Affton, MO
- Affton Fire Protection District
- Farah Alhalabi
- Redona Apostoli
- Sarah Auer
- Natasha Austin
- Julia Broida
- Browns Crossroad Corp
- Cathleen Bush
- Janice G Butler
- Cabson Consulting, LLC
All providers in Affton, MO · Behavior Technician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.