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Individual

MRS. ANNETTE GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDCA

Contact information

Practice address
16001 HOLMES AVE, CLEVELAND, OH 44110-2460
(216) 352-0200
Mailing address
1624 RYDALMOUNT RD, CLEVELAND HTS, OH 44118-1352
(216) 716-9998

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.171746
OH
175T00000X
Peer Specialist
Primary
OH

Other

Enumeration date
11/26/2019
Last updated
02/20/2023
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