Individual
DAVID GIBSON
Active
Individual
DAVID GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11191
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025840
P1
MN
01
—
123775
UC
MN
01
—
12D53GI
BCBS
MN
01
—
46411
HP
MN
05
—
475526000
—
MN
01
—
62-51344
UBH
MN
Enumeration date
07/27/2006
Last updated
01/27/2009
Update your record
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