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Individual

DOMINIQUE BIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHS

Contact information

Practice address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(267) 547-0103
(267) 754-6511
Mailing address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(267) 547-0103
(267) 754-6511

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/26/2018
Last updated
09/26/2018
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