Most Relevant Information
Provider Data
| NPI Number: | 1003330515 |
| Provider Name: | SHERIDAN TIHISTA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/27/2017 |
| Last Updated: | 03/09/2020 |
Provider Practice Location
4817 EHRLICH RD
TAMPA
FL
336242037
Practice Location Phone/Fax
| Phone: | 3523328588 |
| Fax: |
Provider Mailing Location
PO BOX 357370
GAINESVILLE
FL
326357370
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |