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Organization

GIBSON WELLNESS GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORI FRANCES GRANT (MANAGER)
(586) 651-0090
Entity
Organization

Contact information

Practice address
801 W BIG BEAVER RD STE 208, TROY, MI 48084-4726
(586) 651-0090
Mailing address
1935 QUARTON RD, BLOOMFIELD, MI 48301-2319
(586) 651-0090

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
09/20/2023
Last updated
09/20/2023
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