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Individual

CARMEN LYNNETTE TIBBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.H.S., SLP-CCC

Contact information

Practice address
725 GLEASON DR, CLARKSVILLE, TN 37042-1123
(931) 401-6776
Mailing address
725 GLEASON DR, CLARKSVILLE, TN 37042-1123
(931) 401-6776

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
CT32520898P
IL
235Z00000X
Speech-Language Pathologist
Primary
309109
KY
235Z00000X
Speech-Language Pathologist
6836
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
309109
STATE OF KENTUCKY
KY
01
6836
STATE OF TENNESSEE
TN
01
CT32520898P
PART C EI CREDENTIAL
IL
Enumeration date
06/05/2007
Last updated
06/11/2026
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