Individual
CONSTANCE BAUCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
79 SAND PEBBLE DR STE A, JACKSON, TN 38305-7591
(901) 443-9146
Mailing address
195 WESTWOOD DR APT 2, TRENTON, TN 38382-3941
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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