Doctor Name: | DONALD L GIBSON |
NPI Number: | 1124418850 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MHRT-CSP |
License Number: | |
Business Practice Address: | 1 Edgemont Dr Presque Isle, ME - 047692036 |
Business Phone Number: | 2077643319 |
Business Fax Number: | 2077645377 |
Mailing Address: | 1 Edgemont Dr, PRESQUE ISLE |
State: | ME |
Postal Code: | 047692036 |
Phone Number: | 2077643319 |
Fax Number: | 2077645377 |
NPI Enumeration Date: | 02/03/2015 |
NPI Last Update Date: | 02/03/2015 |
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: |