Provider Information for 1609274737
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STACY L GIBSON LPC
Sex: Female
NPI: 1609274737
Last Updated: 2014-12-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1609274737 | ||||||||
| Enumeration Date | 2014-12-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 610 CAMPUS DR ABINGDON, VA 24210-2589 United States Phone: 276-525-1587 | Fax:276-525-1609 | ||||||||
| Primary Practice Address | 610 CAMPUS DR ABINGDON, VA 24210-2589 United States Phone: 276-525-1587 | Fax:276-525-1609 | ||||||||
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