Provider Demographics
NPI:1619314267
Name:ALLBETTER, TABITHA LINN
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:LINN
Last Name:ALLBETTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:LINN
Other - Last Name:LEDBETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20133 SW CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:OR
Mailing Address - Zip Code:97378-9818
Mailing Address - Country:US
Mailing Address - Phone:503-881-9470
Mailing Address - Fax:
Practice Address - Street 1:5820 NE RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8420
Practice Address - Country:US
Practice Address - Phone:503-881-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health