| Doctor Name: | MS. GEORGIA D. GIBSON |
| NPI Number: | 1003932732 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2611 Liberty Hill Rd Camden, SC - 290201871 |
| Business Phone Number: | 8034325323 |
| Business Fax Number: | 8037133978 |
| Mailing Address: | 215 N Magnolia St, SUMTER |
| State: | SC |
| Postal Code: | 291504943 |
| Phone Number: | 8037759364 |
| Fax Number: | 8037736615 |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |