Doctor Name: | DINELLY HOLDER GIBSON |
NPI Number: | 1013253897 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, NCC, CCMHC |
License Number: | |
Business Practice Address: | 2667 Nottingham Way Suite #3 Hamilton, NJ - 086194116 |
Business Phone Number: | 6098909998 |
Business Fax Number: | |
Mailing Address: | 2667 Nottingham Way, Suite #3 HAMILTON |
State: | NJ |
Postal Code: | 086194116 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/22/2012 |
NPI Last Update Date: | 12/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |