Individual
MRS. TABATHA DEAS ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2810 ASHLEY PHOSPHATE RD STE B11, NORTH CHARLESTON, SC 29418-6406
(843) 813-1538
Mailing address
966 GOVERNORS CT, MOUNT PLEASANT, SC 29464-9257
(843) 813-1538
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48578
SC
106E00000X
Assistant Behavior Analyst
0-14-6299
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BB1018
—
SC
Enumeration date
01/21/2015
Last updated
04/05/2021
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