| NPI | 1043617152 |
|---|---|
| Former Name | LAURA N GIBBENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2017031254) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 2704) |
| 101YP2500X Counselor Professional (Licence: KS 2548) | |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2022-10-19 |