Individual
MOLLY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 W SUNNYSIDE AVE, CHICAGO, IL 60640-5684
(773) 935-6126
Mailing address
1025 W SUNNYSIDE AVE, CHICAGO, IL 60640-5684
(203) 640-4856
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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