Individual
TABITHA DENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
613 W 2ND ST STE 4, ROSWELL, NM 88201-4671
(919) 255-0136
Mailing address
2105 S PENNSYLVANIA AVE UNIT B, ROSWELL, NM 88203-4157
(919) 255-0136
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-10426
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-10426
NONE
NM
Enumeration date
01/10/2019
Last updated
01/10/2019
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