Provider Demographics
NPI:1164174322
Name:CRABTREE, TABITHA (MA)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2749
Mailing Address - Country:US
Mailing Address - Phone:407-748-2442
Mailing Address - Fax:
Practice Address - Street 1:238 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2749
Practice Address - Country:US
Practice Address - Phone:407-748-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist