Tara S Feddon
Behavior Technician in Stuart, FL. Individual provider (NPI-1).
NPI number1114656113
StatusActive
Last updated in NPPESJun 7, 2022
Details
- NPI
- 1114656113
- Entity type
- Individual (NPI-1)
- Name
- Tara S Feddon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2022
- Certification date
- Jun 7, 2022
- Last updated
- Jun 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-21-164064 | FL | Yes |
Practice location
821 Se Ocean BlvdStuart, FL 34994-2456
Phone 772-872-6940 · Fax 772-209-6900
Mailing address
4241 Ne Cheri DrJensen Beach, FL 34957-3823
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