Individual
ALICE MARIE TIBBALS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
201 W PATISON ST STE A, PORT HADLOCK, WA 98339-9794
(360) 382-7006
(360) 382-7009
Mailing address
201 W PATISON ST STE A, PORT HADLOCK, WA 98339-9794
(360) 382-7006
(360) 382-7009
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60335080
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042543
—
WA
Enumeration date
02/20/2013
Last updated
03/01/2018
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