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NPI Code Detail

MEDICARE: JACQUELINE PECORARO

MEDICARE: JACQUELINE PECORARO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianRBT-21-158908MO

General Provider Information

NPI Number : 1740885128
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE PECORARO
Provider Business Mailing Address
First Line : 306 N KENSINGTON AVE
Second Line :
City : LA GRANGE PARK
State : IL
Zip : 60526-1870
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3859 FEE FEE RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2937
Country : US
Telephone Number : 314-410-9670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 05/13/2024

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Directions to “ JACQUELINE PECORARO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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