Organization
PAULETTE R GIBBONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULETTE RENE GIBBONS MS LMHC MCAP (THERAPIST)
(786) 374-8100
Entity
Organization
Contact information
Practice address
1830 RADIUS DR, APT 604, HOLLYWOOD, FL 33020-7702
(786) 374-8100
Mailing address
1830 RADIUS DR, APT 604, HOLLYWOOD, FL 33020-7702
(786) 374-8100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
MCAP100270
FL
251S00000X
Community/Behavioral Health Agency
Primary
MH14006
FL
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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