Individual
DR. DOUGLAS P GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1250 E MARSHALL ST, PSYCHIATRY, RICHMOND, VA 23298-5051
(804) 827-0053
(804) 828-7814
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003551
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010204046 541581185
—
VA
Enumeration date
10/16/2006
Last updated
06/11/2010
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