Provider Demographics
NPI:1073248266
Name:NELSON, TABITHA (BSW)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 CANNON WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-2932
Mailing Address - Country:US
Mailing Address - Phone:615-525-0102
Mailing Address - Fax:
Practice Address - Street 1:1420 DONELSON PIKE STE B19
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2999
Practice Address - Country:US
Practice Address - Phone:629-895-5376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker