Provider Demographics
NPI:1003395450
Name:ARRINGTON, TIARA (RBT-18-62532)
Entity Type:Individual
Prefix:
First Name:TIARA
Middle Name:
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:RBT-18-62532
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WINSLOW ST
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-1422
Mailing Address - Country:US
Mailing Address - Phone:708-407-3648
Mailing Address - Fax:
Practice Address - Street 1:81 WINSLOW ST
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-1422
Practice Address - Country:US
Practice Address - Phone:708-407-3648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-18-62532106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician