Individual
MS. ELLIANNA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
933 NE 107TH ST, MIAMI, FL 33161-7313
(305) 741-4648
Mailing address
933 NE 107TH ST, MIAMI, FL 33161-7313
(305) 741-4648
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT 2953
FL
Other
Enumeration date
11/24/2015
Last updated
01/23/2016
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