Individual
CONNIE J GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW LICSW
Contact information
Practice address
540 E 1ST ST, WACONIA, MN 55387-1600
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1600
(952) 442-4437
(952) 442-3084
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LICSW4945
MN
Other
Enumeration date
03/15/2007
Last updated
02/19/2014
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