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Individual

DR. JAMES LYLE BIBB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
45-020A MALULANI STREET, KANEOHE, HI 96744-2433
(808) 375-1850
(808) 235-6622
Mailing address
45-020A MALULANI STREET, KANEOHE, HI 96744-2433
(808) 375-1850
(808) 235-6622

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY387
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
192823
HMN SUMMERLIN NUMBER
HI
01
192823 / I1
HMA INC. DBA MANAGEMENT
HI
01
9412-8
HMSA PROVIDER NUMBER
HI
01
PSY387
MDX HAWAII
HI
Enumeration date
09/14/2006
Last updated
04/03/2024
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