Healthcare Provider Details

I. General information

NPI: 1366359499
Provider Name (Legal Business Name): CHRISTIANE TIBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4708 MARIGNY ST
NEW ORLEANS LA
70122-5021
US

IV. Provider business mailing address

42 MAPLEWOOD AVE
HEMPSTEAD NY
11550-6414
US

V. Phone/Fax

Practice location:
  • Phone: 718-407-0729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA9103
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: