Individual
MRS. ELIZABETH GIBSON-PARUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW, QMHP
Contact information
Practice address
1010 E WEST MAPLE RD, WALLED LAKE, MI 48390-3571
(248) 313-2900
Mailing address
1010 E WEST MAPLE RD, WALLED LAKE, MI 48390-3571
(248) 313-2900
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802086955
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171M00000X
—
MI
Enumeration date
02/21/2014
Last updated
01/27/2016
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