Individual
JESSICA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1276 W 3RD ST, CLEVELAND, OH 44113-1514
(216) 443-3762
Mailing address
1276 WEST 3RD ST, CLEVELAND, OH 44113
(216) 443-3762
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1300002
OH
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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