Provider Demographics
NPI:1134305998
Name:DEWEESE-GIDDINGS, TAMELA C (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:TAMELA
Middle Name:C
Last Name:DEWEESE-GIDDINGS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12354 LAVENDER LOOP
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-2971
Mailing Address - Country:US
Mailing Address - Phone:941-729-5941
Mailing Address - Fax:
Practice Address - Street 1:12354 LAVENDER LOOP
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-2971
Practice Address - Country:US
Practice Address - Phone:941-729-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist