Individual
MS. JALISA VONETT GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 E MILL ST, KINGSTREE, SC 29556-3428
(843) 355-9922
Mailing address
128 E MILL ST, KINGSTREE, SC 29556-3428
(843) 335-9922
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
SC
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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