Individual
MR. CHANCE TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APSS
Contact information
Practice address
195 COUNTY ROAD 1024, CUNNINGHAM, KY 42035-9324
(270) 442-7121
(270) 933-1056
Mailing address
195 COUNTY ROAD 1024, CUNNINGHAM, KY 42035-9324
(270) 442-7121
(270) 933-1056
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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