Individual
MS. LAURA S GIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2830 W GLENDALE AVE # 16, PHOENIX, AZ 85051-8400
(602) 455-4626
(605) 455-4624
Mailing address
2830 W GLENDALE AVE # 16, PHOENIX, AZ 85051-8400
(602) 455-4626
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-10899
AZ
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
314903
—
AZ
Enumeration date
03/17/2008
Last updated
03/10/2021
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