Individual
JUSTIN GEORGE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N 5TH ST, HUGO, OK 74743-4005
(580) 775-9191
Mailing address
PO BOX 105, BOKCHITO, OK 74726-0105
(580) 775-9191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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