Individual
DR. GILLIAN TIBBETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
16180 HASTINGS AVE SE STE 205, PRIOR LAKE, MN 55372-9228
(952) 443-4600
Mailing address
1772 STIEGER LAKE LN, VICTORIA, MN 55386-7723
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6599
MN
Other
Enumeration date
07/23/2019
Last updated
10/02/2020
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