Individual
DR. TRACY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW, LMSW, LCSWA
Contact information
Practice address
14969 SANTA LUCIA DR, CHARLOTTE, NC 28277-3382
(540) 577-2400
Mailing address
PO BOX 473864, CHARLOTTE, NC 28247-3864
(704) 412-1896
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
13362
SC
104100000X
Social Worker
4680G
AL
104100000X
Social Worker
Primary
P014226
NC
Other
Enumeration date
10/18/2019
Last updated
01/27/2020
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