Doctor Name: | JANE CHANDLER GIBBONS |
NPI Number: | 1639353436 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 2003006010 |
Business Practice Address: | 9137 Old Bonhomme Rd Olivette, MO - 631324417 |
Business Phone Number: | 3149977002 |
Business Fax Number: | 3149976848 |
Mailing Address: | 9137 Old Bonhomme Rd, OLIVETTE |
State: | MO |
Postal Code: | 631324417 |
Phone Number: | 3149977002 |
Fax Number: | 3149976848 |
NPI Enumeration Date: | 12/28/2007 |
NPI Last Update Date: | 12/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 2003006010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |