Provider Demographics
NPI:1811315328
Name:BIBLER, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:BIBLER
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 1:232 BURNETT AVE S
Mailing Address - Street 2:APT. A113
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:232 BURNETT AVE S
Practice Address - Street 2:APT. A113
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2107
Practice Address - Country:US
Practice Address - Phone:707-499-5279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor