Provider Demographics
NPI:1699820613
Name:DUNCAN, TASHAWNA K (PHD)
Entity Type:Individual
Prefix:DR
First Name:TASHAWNA
Middle Name:K
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5245 OFFICE PARK BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3444
Mailing Address - Country:US
Mailing Address - Phone:941-751-7545
Mailing Address - Fax:941-755-2514
Practice Address - Street 1:5245 OFFICE PARK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3444
Practice Address - Country:US
Practice Address - Phone:941-751-7545
Practice Address - Fax:941-755-2514
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6421103G00000X, 103TB0200X, 103TC2200X, 103T00000X, 103TM1800X, 103TC0700X
FLPY 6421103TS0200X, 103TF0200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73007Medicare ID - Type Unspecified