Individual
ANTHONY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1920 S 9TH ST, IRONTON, OH 45638
(740) 479-5120
Mailing address
PO BOX 396, SPRINGBORO, OH 45066-0396
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162494
OH
104100000X
Social Worker
S.2207357
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/05/2018
Last updated
11/07/2023
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