Provider Demographics
NPI:1851538136
Name:STREFF, TODD MATTHEW (BCBA)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:MATTHEW
Last Name:STREFF
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LEXINGTON OAKS CT
Mailing Address - Street 2:
Mailing Address - City:FORISTELL
Mailing Address - State:MO
Mailing Address - Zip Code:63348-1479
Mailing Address - Country:US
Mailing Address - Phone:314-308-1141
Mailing Address - Fax:
Practice Address - Street 1:19 LEXINGTON OAKS CT
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348-1479
Practice Address - Country:US
Practice Address - Phone:636-673-2000
Practice Address - Fax:636-673-2000
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-00-0198103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst