Most Relevant Information
Provider Data
| NPI Number: | 1003315920 |
| Provider Name: | TRACY DUCKETT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/06/2018 |
| Last Updated: | 02/06/2018 |
Provider Practice Location
801 BIRCHFIELD DR
MOUNT LAUREL
NJ
080544015
Practice Location Phone/Fax
| Phone: | 4846812170 |
| Fax: |
Provider Mailing Location
583 SHOEMAKER RD STE 230
KING OF PRUSSIA
PA
194064201
Provider Mailing Phone/Fax
| Phone: | 4846812170 |
| Fax: |