Individual
SHANESE TASHAUN HIBBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4818 OLCOTT AVE APT 1, EAST CHICAGO, IN 46312-3404
(219) 276-9943
Mailing address
4818 OLCOTT AVE APT 1, EAST CHICAGO, IN 46312-3404
(219) 276-9943
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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