Individual
JAMES EDWARD GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC II
Contact information
Practice address
420 21ST AVE STE 113, LONGMONT, CO 80501-1441
(303) 834-9369
Mailing address
420 21ST AVE, LONGMONT, CO 80501-1441
(033) 834-9369
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0008568
CO
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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