Individual
MR. GEORGE FARRELL GIBSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A. MHP
Contact information
Practice address
502 N MARKET ST, CHAMPAIGN, IL 61820-3634
(217) 373-2428
Mailing address
903 HARTWELL DR, APT #7, SAVOY, IL 61874-9749
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2010
Last updated
08/21/2010
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