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Individual

AMANDA GIBBONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
59 KATE WAGNER RD, WESTMINSTER, MD 21157-6957
(410) 848-2500
Mailing address
59 KATE WAGNER RD, WESTMINSTER, MD 21157-6957
(410) 848-2500

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
26305
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110026265E
MA
Enumeration date
06/18/2015
Last updated
04/29/2022
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