Individual
ALLISON HIBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LAADC-CA
Contact information
Practice address
2494 LAKE TAHOE BLVD STE B7, SOUTH LAKE TAHOE, CA 96150-7142
(530) 600-6505
Mailing address
PO BOX 19007, S LAKE TAHOE, CA 96151-0007
(530) 600-6505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
06577-PC
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCI12030518
CA
106H00000X
Marriage & Family Therapist
Primary
123915
CA
106H00000X
Marriage & Family Therapist
3308-R
NV
Other
Enumeration date
09/25/2013
Last updated
01/24/2022
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