Individual
STARR TIBBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 JUANIPERO WAY, MEDFORD, OR 97504-8580
(541) 505-8426
(541) 515-6938
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
PROFESSIONALLICENSE
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/10/2015
Last updated
02/08/2023
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