Individual
FAITH GIBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 MONTEVUE LN, FREDERICK, MD 21702-8214
(240) 457-1827
Mailing address
350 MONTEVUE LN, FREDERICK, MD 21702-8214
(240) 457-1827
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
20657
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410762400
—
MD
Enumeration date
11/01/2018
Last updated
10/20/2021
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