Provider Demographics
NPI:1609141621
Name:GARTON, TABITHA C (LPC-IT)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:C
Last Name:GARTON
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:C
Other - Last Name:YOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1814 APPLETON RD
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-1110
Mailing Address - Country:US
Mailing Address - Phone:920-731-7445
Mailing Address - Fax:920-731-7490
Practice Address - Street 1:1814 APPLETON RD
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-1110
Practice Address - Country:US
Practice Address - Phone:920-731-7445
Practice Address - Fax:920-731-7490
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1333-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional