Individual
DEBRA ELAINE GIBSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
Mailing address
1900 N OSAGE ST, PONCA CITY, OK 74601-1144
(580) 762-1812
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2753
OK
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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