Most Relevant Information
Provider Data
| NPI Number: | 1003455445 |
| Provider Name: | TYMELL THOMAS RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-19-104536 |
Most Important Dates
| Enumeration Date: | 01/02/2020 |
| Last Updated: | 01/02/2020 |
Provider Practice Location
4203 PINE ST
MARIANNA
FL
324482819
Practice Location Phone/Fax
| Phone: | 8506934748 |
| Fax: |
Provider Mailing Location
7108 S KANNER HWY
STUART
FL
349977462
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |