Individual
MARIO GIBSON FRANCISCOTTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLPC
Contact information
Practice address
6200 EGYPT VALLEY CT NE, ADA, MI 49301-9660
(616) 295-0691
Mailing address
6200 EGYPT VALLEY CT NE, ADA, MI 49301-9660
(616) 295-0691
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401010137
MI
Other
Enumeration date
01/19/2016
Last updated
03/03/2016
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