Provider Demographics
NPI:1518746080
Name:HIBNER, ANNETTE RAE (LMFT-IT)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:RAE
Last Name:HIBNER
Suffix:
Gender:F
Credentials:LMFT-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 8TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1875
Mailing Address - Country:US
Mailing Address - Phone:608-448-2497
Mailing Address - Fax:608-448-2865
Practice Address - Street 1:1212 8TH ST STE 3
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1875
Practice Address - Country:US
Practice Address - Phone:608-448-2497
Practice Address - Fax:608-448-2865
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1046-128106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist