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Individual

SHANE TARKIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5959 LAKE ELLENOR DR, ORLANDO, FL 32809-4633
(321) 972-4039
Mailing address
1154 SW 25TH AVE, BOYNTON BEACH, FL 33426-7444

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-25-16010
FL
106S00000X
Behavior Technician
RBT-22-243636
FL

Other

Enumeration date
11/14/2022
Last updated
04/13/2025
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