Individual
SCOTT GIBSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2015 MAXWELL AVE, EVANSVILLE, IN 47711-4359
(812) 422-7974
(812) 671-0627
Mailing address
2015 MAXWELL AVE, EVANSVILLE, IN 47711-4359
(812) 422-7974
(812) 671-0627
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000754A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353772
ANTHEM PIN
IN
Enumeration date
06/16/2006
Last updated
08/13/2024
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