Individual
CANDICE KIERA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
(762) 408-4076
Mailing address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801104207
MI
Other
Enumeration date
06/14/2020
Last updated
02/29/2024
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