Individual
SHONDA TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
481 NORRIS RD, BOWLING GREEN, KY 42101-8024
(270) 792-0262
Mailing address
481 NORRIS RD, BOWLING GREEN, KY 42101-8024
(270) 792-0262
(270) 904-5110
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7329
KY
1041C0700X
Clinical Social Worker
Primary
253280
KY
1041C0700X
Clinical Social Worker
7329
KY
Other
Enumeration date
09/09/2015
Last updated
11/08/2021
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