Individual
MICHELLE TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
650 NW SONORA DR, BEND, OR 97703-1190
(541) 389-7499
Mailing address
100 PARK ST, CISNE, IL 62823-9437
(615) 487-5206
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
329946
OR
225X00000X
Occupational Therapist
4807
CO
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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