Stefanie Marie Gibbons, ASW
Student in an Organized Health Care Education/Training Program in Coarsegold, CA. Individual provider (NPI-1).
NPI number1982205217
StatusActive
Last updated in NPPESJul 22, 2023
Details
- NPI
- 1982205217
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Stefanie Marie Gibbons
- Credential
- ASW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 3, 2020
- Certification date
- Jul 22, 2023
- Last updated
- Jul 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | 1982205217 | CA | Yes |
Other names
- Stefanie Marie Wallace (Former Name)
Practice location
45340 Windmill RdCoarsegold, CA 93614-9345
Phone 281-468-1094
Mailing address
45340 Windmill RdCoarsegold, CA 93614-9345
Phone 281-468-1094
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