Healthcare Provider Details

I. General information

NPI: 1669224994
Provider Name (Legal Business Name): HIBBARD PSYCHOLOGICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4626 DELWOOD VIEW BLVD
PANAMA CITY BEACH FL
32408-7107
US

IV. Provider business mailing address

4626 DELWOOD VIEW BLVD
PANAMA CITY BEACH FL
32408-7107
US

V. Phone/Fax

Practice location:
  • Phone: 949-373-3640
  • Fax:
Mailing address:
  • Phone: 949-373-3640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOLEE W HIBBARD
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSYD
Phone: 949-374-0247