Provider Demographics
NPI:1164955076
Name:SPEAKS, TABITHA (MA)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:SPEAKS
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 1:201 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2183
Mailing Address - Country:US
Mailing Address - Phone:864-682-0589
Mailing Address - Fax:
Practice Address - Street 1:123 W PUBLIC SQ STE D
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2961
Practice Address - Country:US
Practice Address - Phone:864-871-9840
Practice Address - Fax:864-715-1580
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6567101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor