Individual
LAUREN TRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
583 SHOEMAKER RD STE 230, KING OF PRUSSIA, PA 19406-4238
(484) 681-2170
Mailing address
583 SHOEMAKER RD STE 230, KING OF PRUSSIA, PA 19406-4238
(484) 681-2170
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-75743
PA
106S00000X
Behavior Technician
RBT-23-269995
PA
Other
Enumeration date
04/23/2024
Last updated
10/21/2024
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