Individual
MARY LYNNE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
5 SUGAR CREEK RD, PIEDMONT, MO 63957-9612
(573) 223-7649
Mailing address
600 SUN TEMPLE DR, MADISON, AL 35758-8643
(256) 288-3333
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4625C
AL
Other
Enumeration date
04/14/2021
Last updated
07/08/2024
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