Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanisha Mack

Individual provider Behavior Technician · NPI 1629688163

Tanisha Mack is a Behavior Technician in Orange Park, Florida. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

1563 Kingsley Ave Ste 103
Orange Park, FL 32073-4503
Phone: (904) 602-9740
Fax: (904) 637-4724
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1629688163
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 7, 2020
Last updated in NPPESAugust 7, 2020
Certification dateAugust 7, 2020
Mailing address300 International Parkway, Suite 200, Lake Mary, FL 32746-3625

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