Individual
DR. CHRISTINE A GIBBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD LP LLC
Contact information
Practice address
9001 E BLOOMINGTON FWY STE 117, BLOOMINGTON, MN 55420-3487
(763) 595-7294
(763) 595-7293
Mailing address
9001 E BLOOMINGTON FWY STE 117, BLOOMINGTON, MN 55420-3487
(952) 406-8132
(952) 456-6368
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4789
MN
103TB0200X
Cognitive & Behavioral Psychologist
LP4789
MN
103TC0700X
Clinical Psychologist
LP4789
MN
103TC1900X
Counseling Psychologist
LP4789
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP4789
MN
103TH0100X
Health Service Psychologist
LP4789
MN
Other
Enumeration date
04/16/2007
Last updated
02/14/2025
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