Provider Demographics
NPI:1922770478
Name:BYRD, TABITHA (QMHS)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2924
Mailing Address - Country:US
Mailing Address - Phone:302-883-9453
Mailing Address - Fax:
Practice Address - Street 1:3700 LANCASTER PIKE STE 305
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1511
Practice Address - Country:US
Practice Address - Phone:302-538-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator