Individual
TRACI DENEE FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74 N PECOS RD STE C, HENDERSON, NV 89074-7344
(702) 778-4500
(702) 832-0244
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0110
NV
Other
Enumeration date
07/23/2017
Last updated
07/21/2022
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