Individual
MRS. JESSICA LYN GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
2937 ROUTE 611 UNIT 15, TANNERSVILLE, PA 18372-6000
(570) 236-8380
(570) 355-4097
Mailing address
1932 KIRTLEY CT, BLAKESLEE, PA 18610-7911
(570) 236-8380
(570) 355-4097
Taxonomy
Speciality
Code
Description
License number
State
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/08/2008
Last updated
10/11/2018
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