Individual
GEORGIA ALEXANDRA GIBSON-PRUIKSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 LEEWARD CT, CHESAPEAKE, VA 23321-2139
(434) 484-2000
Mailing address
22786 COURTLAND PARK DR, BRAMBLETON, VA 20148-5600
(571) 999-3383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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