Tasha Olin
Individual provider Active NPI Behavior Analyst · Imperial, MO
NPI 1467061200 · NPPES record last updated May 10, 2024
Key facts
- NPI
- 1467061200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 2024014262 (MO)
- Practice address
- 2778 Mallard CT
Imperial, MO 63052-1436 - Phone
- (636) 376-7621
- NPI assigned
- Jul 28, 2020
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024014262 | MO | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA Squad Inc | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 2024014262 | MO | Yes |
Addresses
Primary practice location
2778 Mallard CT
Imperial, MO 63052-1436
Mailing address
2778 Mallard CT
Imperial, MO 63052-1436
Phone (636) 376-7621
Other providers in Imperial, MO
- Conner Naes
- Tamera Newberry
- Nextstep for Life, Inc.
- Theresa Renee Nickolaus
- Matthew Thomas Nosser II
- Alexis Olson
- Madison Lynn Owens
- Lauren Michelle Palazzolo
- Kelly Marie Pantazo
- Megan Parsley
All providers in Imperial, MO · Behavior Analyst in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 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.