Individual
TABATHA COODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 22ND ST, ASHLAND, KY 41101-7803
(606) 324-1141
(606) 325-8606
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
UNLICENSED
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
04/19/2013
Last updated
04/19/2013
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