Most Relevant Information
Provider Data
| NPI Number: | 1003408337 |
| Provider Name: | TABITHA JENNY |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/08/2021 |
| Last Updated: | 02/08/2021 |
Provider Practice Location
150 AUTUMN LN APT 5T
BECKLEY
WV
258012951
Practice Location Phone/Fax
| Phone: | 3045731753 |
| Fax: |
Provider Mailing Location
150 AUTUMN LN APT 5T
BECKLEY
WV
258012951
Provider Mailing Phone/Fax
| Phone: | 3045731753 |
| Fax: |