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Individual

MS. ALIX MATTY GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
20 HOUGHTON ST, SUITE 211, SAINT ALBANS, VT 05478-2227
(802) 524-4953
(802) 527-5404
Mailing address
20 HOUGHTON ST, SUITE 211, SAINT ALBANS, VT 05478-2227
(802) 524-4953
(802) 527-5404

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0890000970
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009725
VT
Enumeration date
03/19/2008
Last updated
03/19/2008
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