Individual
ALICE JEAN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
9415 S WESTERN AVE, SUITE 117, CHICAGO, IL 60643-6700
(773) 297-2401
Mailing address
3146 W 85TH ST, CHICAGO, IL 60652-3429
(773) 297-2401
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.006485
IL
Other
Enumeration date
03/05/2009
Last updated
10/06/2016
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