Individual
REBECCA CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
632 JAMESTOWN ST, PHILADELPHIA, PA 19128-1705
(908) 461-2177
Mailing address
632 JAMESTOWN ST, PHILADELPHIA, PA 19128-1705
(908) 461-2177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28458
—
Other
Enumeration date
06/04/2018
Last updated
12/05/2024
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