Provider Demographics
NPI:1881466688
Name:PAPPAS, TEAH (RBT)
Entity type:Individual
Prefix:
First Name:TEAH
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 GANDY BLVD N APT 1010
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2319
Mailing Address - Country:US
Mailing Address - Phone:904-607-9876
Mailing Address - Fax:
Practice Address - Street 1:30250 SOUTHWELL LN
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5926
Practice Address - Country:US
Practice Address - Phone:813-470-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-303494106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician