Basic Information
| Provider Information | |||||||||
| NPI: | 1497944706 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIBBS | ||||||||
| FirstName: | DEBORAH | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 452 W MARKET ST | ||||||||
| Address2: | |||||||||
| City: | XENIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453852815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373768700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1522 EAST US ROUTE 36 | ||||||||
| Address2: | SUITE A | ||||||||
| City: | URBANA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9376535583 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2007 | ||||||||
| LastUpdateDate: | 05/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | S0031183 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.