Individual
MR. NATHAN W. GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2005 N 900 E, PROVO, UT 84602-1763
(801) 422-5609
(801) 422-0856
Mailing address
4601 SPRUCE CIR, CEDAR HILLS, UT 84062-7703
(801) 216-4434
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
322256-3501
UT
1041C0700X
Clinical Social Worker
992679
CO
Other
Enumeration date
01/22/2007
Last updated
01/13/2014
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