Individual
WENDY TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
310 E BROADWAY AVE, JACKSON, WY 83001-8636
(307) 257-5487
Mailing address
PO BOX 11231, JACKSON, WY 83002-1231
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37139
WY
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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