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Individual

MRS. HEIDI A GIBBONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3506 N US HIGHWAY 51, JANESVILLE, WI 53545-0726
(608) 757-5859
Mailing address
508 CHURCH ST, CLINTON, WI 53525-9493
(608) 290-0842

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7154-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40990700
WI
Enumeration date
01/11/2007
Last updated
01/20/2011
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