Individual
MS. MARIEA GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CMMP
Contact information
Practice address
110 PERRY OAKS LN., COLUMBIA, SC 29229
(803) 404-2559
Mailing address
110 PERRY OAKS LN., COLUMBIA, SC 29229
(803) 404-2559
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
7141
SC
Other
Enumeration date
09/10/2012
Last updated
07/16/2014
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