Individual
MRS. TRACY LEBARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
80 W GRAND ST, ELIZABETH, NJ 07202-1471
(908) 354-3040
Mailing address
703 TOWER DR, EDGEWATER, NJ 07020-2211
(862) 703-0852
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1-14-15844
NJ
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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