Individual
JEANNIE ELIZABETH GIBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 HIGH ST, PORTLAND, ME 04101-2831
(207) 939-1915
Mailing address
200 HIGH ST, PORTLAND, ME 04101-2831
(207) 939-1915
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC3054
ME
Other
Enumeration date
02/04/2007
Last updated
07/08/2007
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