Individual
KELLY GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC SLP
Contact information
Practice address
601 CLYDE AVE NW, WILSON, NC 27893-2335
(229) 563-0364
Mailing address
601 CLYDE AVE NW, WILSON, NC 27893-2335
(229) 563-0364
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9569
NC
Other
Enumeration date
04/05/2012
Last updated
03/25/2022
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