Individual
STEPHANIE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600B N LAKE DR, SALEM, SC 29676-2406
(864) 364-7933
Mailing address
PO BOX 1324, SENECA, SC 29679-1324
(864) 364-7933
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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