Provider Demographics
NPI:1316669831
Name:COLLINS, TABITHA (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E FLAMINGO RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5124
Mailing Address - Country:US
Mailing Address - Phone:702-659-7172
Mailing Address - Fax:702-659-7172
Practice Address - Street 1:2295 E SAHARA AVE STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4113
Practice Address - Country:US
Practice Address - Phone:702-659-7172
Practice Address - Fax:702-659-7172
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst