Individual
BETHANY DAWN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(937) 387-6395
Mailing address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(937) 387-6395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.178418
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCII.161822
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/30/2017
Last updated
11/17/2022
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