Individual
GERALD J GIBCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
320 21ST ST N, MENOMONIE, WI 54751-2228
(715) 235-4537
Mailing address
208 WISCONSIN ST N APT 213, HUDSON, WI 54016-1063
(715) 386-1399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1887132
WI
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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