MEDICARE: TRACI LEE DUCHARME

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1760330344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI LEE DUCHARME

Provider Business Mailing Address
First Line	:	9811 MAGNOLIA VIEW CT APT 204
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-4651
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5844 OLD PASCO RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-4025
Country	:	US
Telephone Number	:	908-938-1577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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Directions to “ TRACI LEE DUCHARME ” Practice Location

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