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Individual
MISTY TABISULA
Active
Individual
MISTY TABISULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CCMH0201901
NM
101Y00000X
Counselor
LPC008435
GA
101YP2500X
Professional Counselor
Primary
LPC008435
GA
106H00000X
Marriage & Family Therapist
CMF0197861
NM
106H00000X
Marriage & Family Therapist
MFT001348
GA
Other
Enumeration date
08/23/2018
Last updated
06/29/2026
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