Fendrick, Tabitha Ann
Fendrick, Tabitha Ann is an individual health care provider with primary practice located at 2500 Hall Ave , Marinette WI 54143-1655. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fendrick, Tabitha Ann can be contacted via phone (715) 732-7700.Contact Information
Primary practice address
2500 Hall Ave
Marinette WI 54143-1655
Phone: (715) 732-7700
Fax: (715) 732-7667
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6801091940 | Michigan |
Profile Details
| NPI number | 1366535957 |
|---|---|
| LBN Legal business name | Fendrick, Tabitha Ann |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Oct 11th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366535957 | NPPES |
| Wisconsin | Other | 8072-123 | STATE OF WISCONSIN DSPS |
| Wisconsin | Other | TF085506 | STATE OF WISCONSIN DSPS |
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