Individual
TIFFANY LECATOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
828 BLACKWOOD CLEMENTON RD APT 104, PINE HILL, NJ 08021-6819
(856) 265-4928
Mailing address
828 BLACKWOOD CLEMENTON RD APT 104, PINE HILL, NJ 08021-6819
(856) 265-4928
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NJ
Other
Enumeration date
12/13/2014
Last updated
12/13/2014
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