Individual
TRACY MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4530 E RAY RD STE 100, PHOENIX, AZ 85044-6095
(480) 608-5210
Mailing address
16025 S 50TH ST APT 3019, PHOENIX, AZ 85048-5022
(630) 915-9639
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/29/2019
Last updated
03/09/2022
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