Individual
DR. MARCIA SUSAN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
404 W BOUGHTON RD STE B, BOLINGBROOK, IL 60440-1898
(630) 759-1732
Mailing address
404 W BOUGHTON RD STE B, BOLINGBROOK, IL 60440-1898
(630) 759-1732
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007322
IL
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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