Individual
TRACI ANN TABER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, BCBA-D
Contact information
Practice address
4647 N 32ND ST STE 255, PHOENIX, AZ 85018-3344
(602) 489-3985
Mailing address
802 MYRTLE ST, HATTIESBURG, MS 39401-4851
(661) 565-5697
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
PSY-005142
AZ
Other
Enumeration date
03/21/2012
Last updated
08/07/2024
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