KELLY TIBBETTS, LICSW

Social Worker - Clinical

Active Individual
NPI: 1992350367

Practice Address

4154 SHORELINE DR STE 202
Spring Park, MN 55384

Phone: (952) 491-9450

Specialties

Specialty Code Primary License
Social Worker - Clinical 1041C0700X Yes 22636 (MN)

Frequently Asked Questions

NPI 1992350367 is the National Provider Identifier for KELLY TIBBETTS, LICSW, a Social Worker - Clinical provider located in Spring Park, MN. This NPI was enumerated on August 2, 2019.
KELLY TIBBETTS, LICSW practices at 4154 SHORELINE DR STE 202, Spring Park, MN 55384.

Quick Facts

NPI
1992350367
Type
Individual
Enumerated
Aug 2, 2019
Last Updated
Jun 6, 2025

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