Individual
MRS. IESHA DOMINIQUE VIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1080 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5012
(470) 516-9950
(470) 221-1821
Mailing address
1080 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5012
(470) 516-9950
(470) 221-1821
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN244291
GA
Other
Enumeration date
11/10/2021
Last updated
10/04/2024
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