Individual
JAKIRA GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 NEPONSET AVE, DORCHESTER, MA 02122-3168
(857) 217-3700
Mailing address
56 W WYOMING AVE, MELROSE, MA 02176-3766
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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