Individual
ELIZABETH GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
260 STETSON ST STE 3200, CINCINNATI, OH 45219-2472
(513) 558-7700
(513) 558-5449
Mailing address
2830 VICTORY PKWY, CINCINNATI, OH 45206-1785
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6378
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
06/28/2006
Last updated
01/10/2019
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