Individual
ANN K. TIBBOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
694 CHURCH ST NE, SALEM, OR 97301-2401
(503) 588-5827
Mailing address
4950 LIBERTY RD S APT 51, SALEM, OR 97306-2424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
N/A
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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