MEDICARE: HAND IN HAND BEHAVIOR THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1528928058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAND IN HAND BEHAVIOR THERAPY LLC

Provider Business Mailing Address
First Line	:	4747 W WATERS AVE APT 3306
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4302 W EL PRADO BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8405
Country	:	US
Telephone Number	:	813-461-5380
Fax Number	:

Authorized Official
Title or Position	:	RBT
Name	:	PATRICK FETHIERE
Credential	:
Telephone Number	:	813-285-9200

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	12/04/2025

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