Provider Demographics
NPI:1689958571
Name:STECKLER-CUCCA, TAMMY (MED, MS, BCBA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:STECKLER-CUCCA
Suffix:
Gender:F
Credentials:MED, MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 SAINT BRIDES RD W
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2237
Mailing Address - Country:US
Mailing Address - Phone:757-408-4924
Mailing Address - Fax:757-500-0132
Practice Address - Street 1:2601 SAINT BRIDES RD W
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-2237
Practice Address - Country:US
Practice Address - Phone:757-421-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-16-24665103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst