Individual
MS. STACIE LEVINE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 BENCHMARK TRL, KILLEEN, TX 76543-5918
(254) 535-0727
Mailing address
2911 BENCHMARK TRL, KILLEEN, TX 76543-5918
(254) 535-0727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8455
TX
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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