Provider Demographics
NPI:1891016101
Name:SHARPE, TOM L JR (BCBA-D)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:L
Last Name:SHARPE
Suffix:JR
Gender:M
Credentials:BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8987 SE STAR ISLAND WAY
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-3127
Mailing Address - Country:US
Mailing Address - Phone:702-241-1718
Mailing Address - Fax:702-974-1475
Practice Address - Street 1:8987 SE STAR ISLAND WAY
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-3127
Practice Address - Country:US
Practice Address - Phone:702-241-1718
Practice Address - Fax:702-974-1475
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-08-4113103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst