Individual
TABITHA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 OAK ST SE APT A105, ALBANY, OR 97322-4702
(541) 971-5078
Mailing address
1605 OAK ST SE APT A105, ALBANY, OR 97322-4702
(541) 971-5078
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
410331
OR
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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