Provider Demographics
NPI:1720445521
Name:TAI, SHARAYAH (BCBA)
Entity Type:Individual
Prefix:
First Name:SHARAYAH
Middle Name:
Last Name:TAI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 W PERDIZ ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7612
Mailing Address - Country:US
Mailing Address - Phone:813-766-9090
Mailing Address - Fax:
Practice Address - Street 1:11215 SHADYBROOK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5711
Practice Address - Country:US
Practice Address - Phone:813-766-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst