Provider Demographics
NPI:1861031882
Name:AARON, TABATHA
Entity Type:Individual
Prefix:
First Name:TABATHA
Middle Name:
Last Name:AARON
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 1:1300 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6929
Mailing Address - Country:US
Mailing Address - Phone:318-448-1801
Mailing Address - Fax:318-448-1841
Practice Address - Street 1:1300 JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6929
Practice Address - Country:US
Practice Address - Phone:318-448-1801
Practice Address - Fax:318-448-1841
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant