Individual
ANNIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCDC
Contact information
Practice address
13741 FOOTHILL BLVD, SUITE 240, SYLMAR, CA 91342-3133
(818) 833-9789
(818) 833-9790
Mailing address
13741 FOOTHILL BLVD, SUITE 240, SYLMAR, CA 91342-3133
(818) 833-9789
(818) 833-9790
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104206
CA
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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