Provider Demographics
NPI:1700038379
Name:CRAVEN, ANGELA (BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9510 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1524
Mailing Address - Country:US
Mailing Address - Phone:314-733-0056
Mailing Address - Fax:314-733-0091
Practice Address - Street 1:9510 PAGE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-1524
Practice Address - Country:US
Practice Address - Phone:314-733-0056
Practice Address - Fax:314-733-0091
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst