Individual
DIANE FAYE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, LSW
Contact information
Practice address
313 HUDGINS ST, LOGAN, WV 25601-3535
(304) 752-7830
(304) 752-7832
Mailing address
313 HUDGINS ST, LOGAN, WV 25601-3535
(304) 752-7830
(304) 752-7832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C362704
WV
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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