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Individual

MADELINE ELIZABETH GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1800 2ND LOOP RD STE 12, FLORENCE, SC 29501-6180
(843) 407-5236
(843) 407-5810
Mailing address
4304 BLUE HERON CIR, FLORENCE, SC 29501-8489
(843) 409-4425

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7326
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7326
BOARD OF OCCUPATIONAL THERAPY
SC
05
TH5894
SC
Enumeration date
08/27/2024
Last updated
04/03/2025
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