Individual
JACQUELINE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3799 CAPE LANDING CIR APT C, MYRTLE BEACH, SC 29588-1123
(845) 313-2012
Mailing address
3799 CAPE LANDING CIR APT C, MYRTLE BEACH, SC 29588-1123
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/10/2013
Last updated
07/25/2022
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