Individual
MR. KEITH GORDON TIBBETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
50 EMERALD DRIVE, HAMPDEN, ME 04444
(207) 307-4505
(207) 941-2955
Mailing address
50 EMERALD DRIVE, HAMPDEN, ME 04444
(207) 307-4505
(207) 941-2955
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL3783
ME
Other
Enumeration date
09/05/2012
Last updated
06/27/2024
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