Provider Demographics
NPI:1366757965
Name:UNIACKE, JOSEPH THOMAS
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:UNIACKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16407 ENCLAVE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-5107
Mailing Address - Country:US
Mailing Address - Phone:813-732-3465
Mailing Address - Fax:813-407-4554
Practice Address - Street 1:16407 ENCLAVE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-5107
Practice Address - Country:US
Practice Address - Phone:813-732-3465
Practice Address - Fax:813-407-4554
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst