Individual
WILLIAM SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
239 MARION LANE, A, GRANTS PASS, OR 97527
(541) 660-9374
Mailing address
7108 SOUTH KANNAR HIGHWAY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10232454
OR
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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