Individual
AMANDA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11605 3RD STREET E, TREASURE ISLAND, FL 33706
(517) 740-5317
Mailing address
11605 3RD ST E, TREASURE ISLAND, FL 33706-4575
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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