Individual
PERSEPHONE HANNAH GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 COLDWATER RD NW, DEWY ROSE, GA 30634-2511
(540) 305-9343
Mailing address
1200 COLDWATER RD NW, DEWY ROSE, GA 30634-2511
(540) 305-9343
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704017698
VA
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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