Individual
MRS. BIANCA TARA IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10439 S 51ST ST, PHOENIX, AZ 85044-5222
(480) 635-9944
Mailing address
743 E SIERRA VISTA DR, PHOENIX, AZ 85014-1221
(480) 406-2979
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-16734
AZ
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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