Provider Demographics
NPI:1861118101
Name:MAY, TABITHA (SWLC)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7935 MT HIGHWAY 35 STE 202
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-5711
Mailing Address - Country:US
Mailing Address - Phone:406-471-1676
Mailing Address - Fax:
Practice Address - Street 1:2282 US HIGHWAY 93 S
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-8499
Practice Address - Country:US
Practice Address - Phone:406-471-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT504001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical