Individual
CANDY ROSE TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 STONEBRIDGE LN, SOUTHLAKE, TX 76092-0306
(817) 431-5778
(817) 337-0446
Mailing address
170 STONEBRIDGE LN, SOUTHLAKE, TX 76092-0306
(817) 431-5778
(817) 337-0446
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208915
TX
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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