| NPI | 1487912705 |
|---|---|
| Former Name | TABITHA LYNN GRANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT3149) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-010451-2015) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH10719) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-08-14 |