Individual
JOHN BRADLEY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
34 MURRAY ST, WATERBURY, CT 06710-1920
(203) 756-8317
Mailing address
34 MURRAY ST, WATERBURY, CT 06710-1920
(203) 756-8317
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104100000X
CT
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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