Individual
ALEXIS GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 MAIN ST, WORCESTER, MA 01608-1604
(508) 752-3969
Mailing address
340 MAIN ST, WORCESTER, MA 01608-1604
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2018
Last updated
09/16/2020
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