Individual
JAYLA ARDAJAH GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2504 BROWNING ROAD 520, GREENWOOD, MS 38930-6022
(662) 897-8049
Mailing address
2504 BROWNING ROAD 520, GREENWOOD, MS 38930-6022
(662) 582-3372
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MS
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TS0200X
School Psychologist
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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