Individual
STEVIE JO NICOLE TIBBETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
24030 INDIAN TOWN RD, COURTLAND, VA 23837-2371
(757) 812-3288
Mailing address
1146 LYNBROOK RD, RUSTBURG, VA 24588-3996
(916) 801-4465
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006589
VA
Other
Enumeration date
07/08/2018
Last updated
01/28/2025
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