Provider Demographics
NPI:1689021867
Name:SIBERT, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SIBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-0726
Mailing Address - Country:US
Mailing Address - Phone:606-681-6390
Mailing Address - Fax:
Practice Address - Street 1:105 CAMPUS DR
Practice Address - Street 2:ADDICTION RECOVERY CARE, LOUISA OFFICE LOCATION
Practice Address - City:ANNBILLE
Practice Address - State:KY
Practice Address - Zip Code:40402
Practice Address - Country:US
Practice Address - Phone:606-681-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist