Individual provider · Type 1 NPI

Tiffany Wisham

Behavior Technician · Jacksonville, FL

NPI number 1003561622 Active

Practice location

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486

Call (855) 832-6727 Map

Mailing address

300 International Pkwy Ste 200
Lake Mary, FL 32746-5028

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician Primary 106S00000XNone listed

Behavior Technician: The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That…

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About NPI 1003561622

Tiffany Wisham's National Provider Identifier is 1003561622, issued on Feb 14, 2022. The primary taxonomy on file is Behavior Technician (106S00000X), and the practice location is in Jacksonville, FL. The record was last updated on Sep 28, 2025.