Provider Demographics
NPI:1780843946
Name:ROGERS, TABITHA YVETTE (BS)
Entity type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:YVETTE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:TABITHA
Other - Middle Name:YVETTE
Other - Last Name:RAMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:5204 SAWYER HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8359
Mailing Address - Country:US
Mailing Address - Phone:901-384-9450
Mailing Address - Fax:901-384-9450
Practice Address - Street 1:3810 WINCHESTER RD
Practice Address - Street 2:SOUTHEAST MENTAL HEALTH CENTER
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6045
Practice Address - Country:US
Practice Address - Phone:901-369-1400
Practice Address - Fax:901-369-1433
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator