Individual
CELESTE HIBBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2036 MEPPEN DR, IDAHO FALLS, ID 83401-5279
(208) 709-0787
Mailing address
2036 MEPPEN DR, IDAHO FALLS, ID 83401-5279
(208) 709-0787
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/14/2020
Last updated
05/14/2020
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