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General NPI Number Information
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NPI Number | 1164955076
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Entity Type | Individual
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Provider Name | TABITHA SPEAKS M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 123 W PUBLIC SQ STE D
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City | LAURENS
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State | SC
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Zip | 29360-2961
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Country | US
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Telephone | 864-871-9840
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Fax | 864-715-1580
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Provider Business Mailing Address
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Address Line | 201 ROBINSON RD
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City | LAURENS
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State | SC
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Zip | 29360-2183
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Country | US
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Telephone | 864-682-0589
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6567
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License Number State | SC
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