Provider Demographics
NPI:1851721880
Name:SYKESHILL, TARA MARIE
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:MARIE
Last Name:SYKESHILL
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 1:7524 REPUBLIC CT APT 301
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-7524
Mailing Address - Country:US
Mailing Address - Phone:703-229-3751
Mailing Address - Fax:
Practice Address - Street 1:4301 N FEDERAL HWY
Practice Address - Street 2:SUITE 2 SOUTH
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6519
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:954-342-0273
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist