Individual
ROBERTA J TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC, HHC
Contact information
Practice address
320 LIBRARY LN, PORTAGE, MI 49002-4303
(269) 329-4551
Mailing address
5518 MONTICELLO AVE, PORTAGE, MI 49024-1211
(269) 492-4488
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401008450
MI
101YM0800X
Mental Health Counselor
6401008450
MI
101YP2500X
Professional Counselor
6401008450
MI
Other
Enumeration date
09/19/2009
Last updated
09/19/2009
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