Organization
JEANNIE GIBERSON, LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE ELIZABETH GIBERSON LCSW (SOLE MEMBER)
(207) 772-0779
Entity
Organization
Contact information
Practice address
200 HIGH ST, PORTLAND, ME 04101-2831
(207) 772-0779
Mailing address
200 HIGH ST, PORTLAND, ME 04101-2831
(207) 772-0779
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC3054
ME
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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