Kibort, Mary Kathleen

Kibort, Mary Kathleen is an sole proprietor health care provider with primary practice located at 785 Wall St , O Fallon IL 62269-1959. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Kibort, Mary Kathleen can be contacted via phone (618) 406-8857.

Contact Information

Primary practice address
785 Wall St O Fallon IL 62269-1959
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2014044614 Missouri
Behavioral Health & Social Service Providers / Professional 101YP2500X 180010634 Illinois

Profile Details

NPI number 1124481312
LBN Legal business name Kibort, Mary Kathleen
Credentials L.C.P.C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2016
Last updated Nov 29th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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