Individual
TRACEY ENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1124 PATRIOT WAY, EASTAMPTON, NJ 08060-9624
(856) 492-1355
Mailing address
49 BROOK DR, BURLINGTON, NJ 08016-3932
(609) 743-2225
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67744
—
Other
Enumeration date
07/02/2024
Last updated
07/16/2024
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