Kimberly Jean Ibarra
Social Worker, Clinical in Grants Pass, OR. Individual provider (NPI-1).
NPI number1841752011
StatusActive
Last updated in NPPESJan 29, 2024
Details
- NPI
- 1841752011
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kimberly Jean Ibarra
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2019
- Certification date
- Jan 29, 2024
- Last updated
- Jan 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | L14621 | OR | Yes |
Practice location
1126 E Jones Creek RdGrants Pass, OR 97526-3714
Phone 541-291-3945
Mailing address
1126 E Jones Creek RdGrants Pass, OR 97526-3714
Phone 541-291-3945
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