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General NPI Number Information
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NPI Number | 1306510276
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Entity Type | Individual
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Provider Name | LAURA DIANNE HIBBS LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 8214 2ND ST NW STE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-1091
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Country | US
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Telephone | 505-317-3792
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Fax | 505-792-6611
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Provider Business Mailing Address
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Address Line | PO BOX 15681
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City | RIO RANCHO
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State | NM
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Zip | 87174-0681
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Country | US
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Telephone | 505-317-3792
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Fax | 505-926-6117
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CTB-2024-0687
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License Number State | NM
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