Individual
ASHTON GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3602 SPRING LAKE RD, JACKSONVILLE, FL 32210-4530
(803) 920-3587
Mailing address
3602 SPRING LAKE RD, JACKSONVILLE, FL 32210-4530
(803) 920-3587
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7817
SC
101YM0800X
Mental Health Counselor
Primary
9404
SC
106S00000X
Behavior Technician
17-46991
SC
Other
Enumeration date
04/06/2018
Last updated
01/17/2024
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