Individual
MS. NICOLE LEE GIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LLSW
Contact information
Practice address
14733 S TELEGRAPH RD, MONROE, MI 48161-9545
(734) 243-8707
(734) 243-8710
Mailing address
14733 S TELEGRAPH RD, MONROE, MI 48161-9545
(734) 243-8707
(734) 243-8710
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801089564
MI
101YM0800X
Mental Health Counselor
Primary
6801089564
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2604097
—
OH
Enumeration date
12/11/2007
Last updated
12/11/2007
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