Individual
GINAVRA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119A MALIBU DR, BATESBURG, SC 29006-2121
(803) 532-8414
(803) 532-4570
Mailing address
301 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7872
(803) 359-3545
(803) 359-2111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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