Provider Demographics
NPI:1851110142
Name:SANDERS, TABITHA (LPC)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14138 S FORT HOOD ST
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4850
Mailing Address - Country:US
Mailing Address - Phone:254-519-1144
Mailing Address - Fax:254-519-1155
Practice Address - Street 1:14138 S FORT HOOD ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4850
Practice Address - Country:US
Practice Address - Phone:254-519-1144
Practice Address - Fax:254-519-1155
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health