Individual
DR. JENNIFER REBECCA SHIBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D., M.S.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003876
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732025
BLUE CROSS BLUE SHIELD
IL
01
—
210732
MEDICARE
IL
Enumeration date
11/16/2007
Last updated
04/30/2010
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