Individual
GARDINER J GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, CADAC
Contact information
Practice address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 983-0351
Mailing address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 983-0351
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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