Jerry U. Gibson, LPC, NCC
Counselor, Professional in Madison, AL. Individual provider (NPI-1).
NPI number1154774966
StatusActive
Last updated in NPPESJul 16, 2016
Details
- NPI
- 1154774966
- Entity type
- Individual (NPI-1)
- Name
- Jerry U. Gibson
- Credential
- LPC, NCC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 16, 2016
- Last updated
- Jul 16, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 3579 | AL | Yes |
Practice location
8089 Highway 72 W Ste DMadison, AL 35758-9531
Phone 256-213-1934
Mailing address
7900 Old Madison Pike Apt 3011Madison, AL 35758-1484
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