Provider Information for 1609421049
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CAMILLE C GIBSON MFT MS
Other Names:Other Name:CAMILLE C GIBSONSex: Female
NPI: 1609421049
Last Updated: 2024-10-09
Certification Date: 2024-10-09
Certification Date: 2024-10-09
Details
| Name | Value | ||||||||||||||||
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| NPI | 1609421049 | ||||||||||||||||
| Enumeration Date | 2019-08-02 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 434 EASTLAND RD BEREA, OH 44017-1217 United States Phone: 440-234-2006 | Fax: | ||||||||||||||||
| Primary Practice Address | 195 N GRANT AVE STE 250 COLUMBUS, OH 43215-2855 United States Phone: 440-260-8300 | Fax: | ||||||||||||||||
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