Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-32807 | FL |
N | 106E00000X | Assistant Behavior Analyst | 0-18-8611 | FL |
NPI | 1154836088 |
---|---|
Provider Name | Skyler Brooke Tharpe |
First Address | Phenix City, AL 36870-7008 |
Second Address | Phenix City, AL 36870-7008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2017 |
Last Update Date | 29/03/2020 |