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Individual

BLISS TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2437 SE 17TH ST, UNIT 102, OCALA, FL 34471-9104
(866) 610-0580
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(866) 610-0580
(866) 610-0580

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
FL
106S00000X
Behavior Technician

Other

Enumeration date
07/11/2018
Last updated
11/25/2020
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