Individual
CHARLES TYLER KIBBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
9209 NW 85TH ST, YUKON, OK 73099-9591
(972) 698-8478
Mailing address
9209 NW 85TH ST, YUKON, OK 73099-9591
(501) 259-3316
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
89025
TX
Other
Enumeration date
07/27/2023
Last updated
12/09/2024
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