Individual
NELLY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5816 FAIRWOOD CIR NW, ACWORTH, GA 30101-4605
(646) 251-8354
Mailing address
5816 FAIRWOOD CIR NW, ACWORTH, GA 30101-4605
(646) 251-8354
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
GA
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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