Individual
DARIA ICHTCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
218 TRIANON LN, VILLANOVA, PA 19085-1442
(703) 506-0123
Mailing address
107 HICKORY LN, MEDFORD, NJ 08055-8713
(609) 204-3966
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37763
—
106S00000X
Behavior Technician
RBT-18-56331
—
Other
Enumeration date
05/22/2018
Last updated
10/14/2019
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