Individual
MS. RENEE VICTORIA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
50 ALDRIN RD, PLYMOUTH, MA 02360-4827
(508) 830-0000
Mailing address
178 HYDE PARK AVE, APT. 2, JAMAICA PLAIN, MA 02130-4133
(518) 860-6842
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
000791-1
NY
Other
Enumeration date
10/23/2007
Last updated
08/05/2010
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