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Individual
SAMANTHA B GIBSON
Active
Individual
SAMANTHA B GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC008325
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC008325
COMMON WEALTH OF PENNSYLVANIA OCCUPATIONAL LICENSE
PA
Enumeration date
06/06/2017
Last updated
08/31/2022
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