Provider Demographics
NPI:1891160461
Name:TABITHA J LAW
Entity Type:Organization
Organization Name:TABITHA J LAW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-331-3743
Mailing Address - Street 1:PO BOX 71123
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78467-1123
Mailing Address - Country:US
Mailing Address - Phone:361-331-3743
Mailing Address - Fax:
Practice Address - Street 1:6838 EVERHART RD APT 1102
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2462
Practice Address - Country:US
Practice Address - Phone:361-331-3743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty