Individual
MS. JEWELL MIRIAM GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
501 CHURCH ST NE STE 208, VIENNA, VA 22180-4734
(703) 570-4104
Mailing address
501 CHURCH ST NE STE 208, VIENNA, VA 22180-4734
(703) 570-4104
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701007652
VA
Other
Enumeration date
05/28/2018
Last updated
05/28/2018
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