MEDICARE: TABITHA WRIGHT

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	:	1891530267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABITHA WRIGHT

Provider Business Mailing Address
First Line	:	4701 N FEDERAL HWY STE 460
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6591
Country	:	US
Telephone Number	:	954-866-1430
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 NW 41ST ST APT 206
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33064-2632
Country	:	US
Telephone Number	:	954-549-4647
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2024
Last Update Date	:	06/27/2024

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Directions to “ TABITHA WRIGHT ” Practice Location

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