Individual
DR. THERESA L. GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11111 CARMEL COMMONS BLVD, SUITE 220, CHARLOTTE, NC 28226-5319
(704) 540-5411
(704) 540-4933
Mailing address
11111 CARMEL COMMONS BLVD, SUITE 220, CHARLOTTE, NC 28226-5319
(704) 540-5411
(704) 540-4933
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2607
NC
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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