Provider Demographics
NPI:1275974834
Name:TARRANT, SEAN DAVID (BCABA)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:DAVID
Last Name:TARRANT
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 KEONIANA ST APT 401
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2022
Mailing Address - Country:US
Mailing Address - Phone:407-616-2345
Mailing Address - Fax:
Practice Address - Street 1:456 KEONIANA ST APT 401
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2022
Practice Address - Country:US
Practice Address - Phone:407-616-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-02-0519106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst