Individual
GAYLA R GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
11042 MANCHESTER RD, KIRKWOOD, MO 63122-6312
(314) 385-9550
Mailing address
5517 ALBIA TERR, JENNINGS, MO 63136-1222
(314) 385-9550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.014685
IL
101YP2500X
Professional Counselor
Primary
2009035067
MO
133NN1002X
Nutrition Education Nutritionist
—
—
174H00000X
Health Educator
—
—
Other
Enumeration date
03/22/2011
Last updated
11/27/2019
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