Individual
MRS. WENDI GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4295
(423) 844-4294
Mailing address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4295
(423) 844-4294
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2479
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2479
TN SLP LICENSE NUMBER
TN
Enumeration date
08/10/2014
Last updated
08/10/2014
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