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General NPI Number Information
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NPI Number | 1336032051
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Entity Type | Individual
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Provider Name | TABATHA WALFORD LLPC
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2200 GREEN RD STE N
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City | ANN ARBOR
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State | MI
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Zip | 48105-2948
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Country | US
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Telephone | 248-573-7417
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 SYLVAN LAKES BLVD APT 510
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City | SYLVANIA
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State | OH
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Zip | 43560-8719
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Country | US
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Telephone | 775-219-3118
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2507323
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6451024327
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License Number State | MI
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