Individual
THERESA MARIA GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3190 HALLMARK CT, SAGINAW, MI 48603-2107
(989) 790-3366
Mailing address
4778 EVA ST, SAGINAW, MI 48601-6917
(989) 798-4773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382341750
—
MI
Enumeration date
03/04/2022
Last updated
03/04/2022
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