Individual
LINDA D TIBBETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 SEMINARY STREET, WARSAW, MO 65355
(660) 438-6993
Mailing address
30191 GREENWOOD DR, EDWARDS, MO 65326-3050
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2003007815
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
578490005
—
MO
Enumeration date
09/16/2008
Last updated
09/16/2008
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