Individual
CAROLNISE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
353 STUBBS MCCORMICK RD, MONROE, LA 71203-9412
(318) 614-5044
Mailing address
353 STUBBS MCCORMICK RD, MONROE, LA 71203-9412
(318) 614-5044
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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