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NPI Code Detail

MEDICARE: TABITHA SPACHT

MEDICARE: TABITHA SPACHT
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
1106S00000XBehavior TechnicianRBT-22-206786IN

General Provider Information

NPI Number : 1740992429
Entity Type Code : Individual
Provider Name (Legal Business Name) : TABITHA SPACHT
Provider Business Mailing Address
First Line : 2785 CASON ST # 2
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2843
Country : US
Telephone Number : 765-446-4185
Fax Number : 765-448-1864
Provider Business Practice Location Address
First Line : 5915 S EMERSON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-1971
Country : US
Telephone Number : 317-567-9307
Fax Number : 765-448-1864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2022
Last Update Date : 12/14/2022

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Directions to “ TABITHA SPACHT ” Practice Location

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