Individual
MRS. JOLANDA CAROL TIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7568 ROUTE 166, CREAL SPRINGS, IL 62922-2700
(814) 952-6195
Mailing address
7568 ROUTE 166, CREAL SPRINGS, IL 62922-2700
(814) 952-6195
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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