Individual
AMANDA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 MACKIN RD, FLINT, MI 48503-1204
(810) 257-3676
Mailing address
1102 MACKIN RD, FLINT, MI 48503-1204
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801095973
MI
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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