Individual
MRS. TRACY ANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 BILTOM RD, WHITE PLAINS, NY 10607-2301
(914) 469-5427
Mailing address
9 BILTOM RD, WHITE PLAINS, NY 10607-2301
(914) 469-5427
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-14-00147
NY
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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