Individual
JENNIFER LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 DEPOT RD, FALMOUTH, ME 04105-1211
(207) 781-8881
(207) 781-8855
Mailing address
50 DEPOT RD, FALMOUTH, ME 04105-1211
(207) 781-8881
(207) 781-8855
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
372839
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
372839
STATE TEACH CERTIFICATE
ME
Enumeration date
07/17/2007
Last updated
07/17/2007
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