Individual
TABATHA GABLE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
301 PINEHAVEN STREET EXT, LAURENS, SC 29360-2671
(864) 984-6584
(864) 984-6464
Mailing address
3406 OLD HWY SOUTH 246, NINETY- SIX, SC 29666
(864) 543-4320
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1911
SC
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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