Provider Demographics
NPI:1194438150
Name:ARANDA, TABITHA ASHLEY MAMIE (LMT)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:ASHLEY MAMIE
Last Name:ARANDA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:ASHLEY MAMIE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:766 S WHITE STATION RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4579
Mailing Address - Country:US
Mailing Address - Phone:901-842-1444
Mailing Address - Fax:
Practice Address - Street 1:3670 S HOUSTON LEVEE RD STE 107
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-9145
Practice Address - Country:US
Practice Address - Phone:901-842-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000007318225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist