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General NPI Number Information
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NPI Number | 1235701301
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Entity Type | Individual
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Provider Name | TAMEKA SHAVON OGLESBY
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Gender | Female
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 6973 UNIVERSITY BLVD
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City | WINTER PARK
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State | FL
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Zip | 32792
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Country | US
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Telephone | 877-995-8478
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 STARR DR
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City | ORLANDO
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State | FL
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Zip | 32818-8507
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Country | US
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Telephone | 407-963-2862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-158064
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License Number State | FL
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