Provider Demographics
NPI:1932526126
Name:ARGIRO, TABETHA NICHOLE (BCABA)
Entity Type:Individual
Prefix:
First Name:TABETHA
Middle Name:NICHOLE
Last Name:ARGIRO
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W. BRANDON BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5122
Mailing Address - Country:US
Mailing Address - Phone:813-438-8902
Mailing Address - Fax:813-438-8903
Practice Address - Street 1:220 W BRANDON BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5104
Practice Address - Country:US
Practice Address - Phone:813-438-8902
Practice Address - Fax:813-438-8903
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-14-5817103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0-14-5817OtherBOARD CERTIFICATION NUMBER