Individual
MATTHEW BYRON GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 E 4TH ST, TULSA, OK 74120-3017
(479) 445-8656
Mailing address
10022 E 29TH ST, TULSA, OK 74129-4409
(479) 445-8656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20254
OK
1041C0700X
Clinical Social Worker
Primary
20254
OK
Other
Enumeration date
07/15/2021
Last updated
03/06/2026
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