Individual
DESIREE AMANDA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9701 PHILADELPHIA CT, LANHAM, MD 20706-4400
(443) 438-6742
Mailing address
9701 PHILADELPHIA CT, LANHAM, MD 20706-4400
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LG23530
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
383876389
—
MD
Enumeration date
01/22/2018
Last updated
01/22/2018
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