Individual
MS. TABATHA SHREE HOLLYWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QBHP
Contact information
Practice address
1109 JONES ST, KENNETT, MO 63857-3824
(873) 888-5925
Mailing address
1109 JONES ST, KENNETT, MO 63857-3824
(873) 888-5925
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
01/20/2026
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