Individual
MISHA KAY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
212 WHITSETT ST, GREENVILLE, SC 29601-3141
(864) 414-1335
Mailing address
4115 WILEY DR, SIMPSONVILLE, SC 29680-6488
(864) 414-1335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11295
SC
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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