Provider Demographics
NPI:1225366446
Name:KIRBY, TABITHA JOY (MA, BCBA, COBA)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:JOY
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MA, BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 FRIDAY RD
Mailing Address - Street 2:
Mailing Address - City:WEST MANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45382-9600
Mailing Address - Country:US
Mailing Address - Phone:614-395-5823
Mailing Address - Fax:
Practice Address - Street 1:607 FRIDAY RD
Practice Address - Street 2:
Practice Address - City:WEST MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45382-9600
Practice Address - Country:US
Practice Address - Phone:614-395-5823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-06-2917103K00000X
OHCOBA.00520103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst