Organization
JERRY DEAN GISON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY GIBSON (OWNER)
(276) 698-8722
Entity
Organization
Contact information
Practice address
125 BROOKDALE DR STE 125, MORGANTOWN, WV 26508-8799
(304) 241-1108
Mailing address
125 BROOKDALE DR STE 125, MORGANTOWN, WV 26508-8799
(304) 241-1108
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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