Individual
MARY CELESTE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
9938 AIRLINE HWY, BATON ROUGE, LA 70816-8193
(225) 424-6800
(225) 424-2182
Mailing address
153 AZALEA DR, LA PLACE, LA 70068-5665
(504) 417-0152
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4882
LA
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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