Individual
JONATHAN GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1127 N KICKAPOO AVE, SHAWNEE, OK 74801-4845
(405) 214-0116
(877) 334-8552
Mailing address
1310 N BEARD AVE, SHAWNEE, OK 74801-4910
(405) 214-0116
(877) 334-8552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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