Provider Demographics
NPI:1154836088
Name:THARPE, SKYLER BROOKE
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:BROOKE
Last Name:THARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 LEE ROAD 437
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-7008
Mailing Address - Country:US
Mailing Address - Phone:334-587-9220
Mailing Address - Fax:
Practice Address - Street 1:73 LEE ROAD 437
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36870-7008
Practice Address - Country:US
Practice Address - Phone:334-587-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-18-8611106E00000X
FL1-18-32807103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst