Individual
MR. DEREK COLUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LBS
Contact information
Practice address
1990 W 3RD ST, WILLIAMSPORT, PA 17701-7808
(570) 320-2816
Mailing address
423 W MAIN ST, LOCK HAVEN, PA 17745-1122
(570) 295-4924
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH005968
PA
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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