MEDICARE: MRS. TABITHA CRABTREE MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA8395	FL

General Provider Information

NPI Number	:	1164174322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TABITHA CRABTREE MA

Provider Business Mailing Address
First Line	:	238 N HIGHLAND AVE
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2749
Country	:	US
Telephone Number	:	407-748-2442
Fax Number	:

Provider Business Practice Location Address
First Line	:	238 N HIGHLAND AVE
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2749
Country	:	US
Telephone Number	:	407-748-2442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2022
Last Update Date	:	01/19/2022

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Directions to “ MRS. TABITHA CRABTREE MA” Practice Location

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