Individual provider · Type 1 NPI

Mara Tibbals

Professional Counselor · West Allis, WI

NPI number 1104600774 Active

Practice location

10150 W National Ave Ste 390
West Allis, WI 53227-2145

Call (414) 545-4430 Map

Mailing address

W142N8220 Merrimac Dr
Menomonee Falls, WI 53051-3947

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X7480-226 (WI)

Professional Counselor: Definition to come...

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About NPI 1104600774

Mara Tibbals's National Provider Identifier is 1104600774, issued on Aug 23, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in West Allis, WI. The record was last updated on Aug 23, 2023.