Individual
ANDREA MICHELLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9000 GLACIER HWY STE 202, JUNEAU, AK 99801-8097
(907) 206-2254
Mailing address
9000 GLACIER HWY STE 202, JUNEAU, AK 99801-8097
(907) 206-2254
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
57801
TX
1041C0700X
Clinical Social Worker
Primary
151996
AK
1041C0700X
Clinical Social Worker
57801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1704229
—
AK
Enumeration date
06/06/2016
Last updated
08/11/2020
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