Provider Demographics
NPI:1043898943
Name:ORR, TABETHA JEAN
Entity Type:Individual
Prefix:
First Name:TABETHA
Middle Name:JEAN
Last Name:ORR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5771
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-5771
Mailing Address - Country:US
Mailing Address - Phone:406-422-4933
Mailing Address - Fax:
Practice Address - Street 1:833 N LAST CHANCE GULCH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3352
Practice Address - Country:US
Practice Address - Phone:406-422-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator