Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003205782 |
---|---|
Provider Name | Tara Scott-Singley |
First Address | Tampa, FL 33619-4466 |
Second Address | Tampa, FL 33619-4466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2015 |
Last Update Date | 17/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103K00000K | TRICARE (01) | FL |