Provider Demographics
NPI:1356626725
Name:GALLERANI, TABITHA (LCSW)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:GALLERANI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 SHERIDAN ST STE 121
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8802
Mailing Address - Country:US
Mailing Address - Phone:954-862-2252
Mailing Address - Fax:833-383-1355
Practice Address - Street 1:9000 SHERIDAN ST STE 121
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-8802
Practice Address - Country:US
Practice Address - Phone:954-862-2252
Practice Address - Fax:833-383-1355
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW111801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical