Organization
DAVID GIBSON LICSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GIBSON LICSW (LICENSED CLINICAL SOCIAL WORKER)
(651) 216-8899
Entity
Organization
Contact information
Practice address
821 RAYMOND AVE STE 200, SAINT PAUL, MN 55114-1509
(651) 216-8899
Mailing address
1945 STANFORD AVE, SAINT PAUL, MN 55105-1655
(651) 216-8899
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11191
MN
Other
Enumeration date
01/27/2009
Last updated
01/27/2009
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