Individual
HEATHER L. GIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW INTERN
Contact information
Practice address
61 MEDFORD ST, SOMERVILLE, MA 02143-3421
(617) 629-3919
Mailing address
54 SAINT GERMAIN ST, APT. 2, BOSTON, MA 02115-3258
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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