Provider Demographics
NPI:1952883399
Name:SCHWARK, TABITHA JAYNE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:JAYNE
Last Name:SCHWARK
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 MILL POND DR.
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065
Mailing Address - Country:US
Mailing Address - Phone:214-384-4437
Mailing Address - Fax:
Practice Address - Street 1:938 MILL POND DR.
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065
Practice Address - Country:US
Practice Address - Phone:214-384-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-01
Last Update Date:2018-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208050224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant