Individual
LATISHA MICHELLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,LCAS-A
Contact information
Practice address
FERNANDEZ COMMUNITY CENTER, 3050 BERKS WAY, RALEIGH, NC 27614
(919) 900-7438
(919) 900-7576
Mailing address
2500 NASH ST N STE E2500, WILSON, NC 27896-1394
(252) 227-1376
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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