Provider Demographics
NPI:1942976162
Name:CHEIFFETZ, TRACEY (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:
Last Name:CHEIFFETZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 TANGLE BRUSH DR APT 147
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2947
Mailing Address - Country:US
Mailing Address - Phone:832-403-1344
Mailing Address - Fax:
Practice Address - Street 1:30106 LEGENDS RIDGE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3036
Practice Address - Country:US
Practice Address - Phone:832-791-2824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst