Individual
COLLEEN GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1411 GROVE AVE, APT 13, RICHMOND, VA 23220
(910) 783-9095
Mailing address
1411 GROVE AVE, APT #13, RICHMOND, VA 23220-4649
(910) 783-9095
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006850
VA
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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