Provider Demographics
NPI:1508544024
Name:ARIZPE, TABITHA SHANNON
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:SHANNON
Last Name:ARIZPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 SHERMAN CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3421
Mailing Address - Country:US
Mailing Address - Phone:858-997-6873
Mailing Address - Fax:
Practice Address - Street 1:1412 TROTWOOD AVE STE 19
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4979
Practice Address - Country:US
Practice Address - Phone:931-222-4107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7522225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist