Individual
TABITHA R WALTON
Active
Individual
TABITHA R WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
122447
CA
1041C0700X
Clinical Social Worker
Primary
9332
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122447
STATE OF CALIFORNIA BOARD OF BEHAVIORAL SCIENCES
CA
01
—
9332
TENNESSEE BOARD OF SOCIAL WORKER LICENSURE
TN
Enumeration date
12/10/2024
Last updated
12/10/2024
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