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Individual

DR. JACOB GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD, LMFT

Contact information

Practice address
11607 LAMPTON VIEW DR, SOUTH JORDAN, UT 84095-7898
(801) 301-2450
Mailing address
11607 LAMPTON VIEW DR, SOUTH JORDAN, UT 84095-7898
(801) 301-2450

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
5642816-3902
UT

Other

Enumeration date
08/05/2012
Last updated
08/05/2012
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