Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1003330515 |
---|---|
Provider Name | Sheridan Tihista |
First Address | Gainesville, FL 32635-7370 |
Second Address | Tampa, FL 33624-2037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2017 |
Last Update Date | 09/03/2020 |