Individual
CARLA PRICE LYBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1726 MAIN ST, ALTON, IL 62002-4709
(618) 368-4214
Mailing address
1726 MAIN ST, ALTON, IL 62002-4709
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150111042
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4A00-IPI-032
—
IL
Enumeration date
04/14/2022
Last updated
06/20/2024
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