| NPI | 1124875398 |
|---|---|
| Other Name | BRAD GIBBS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2024029145) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2025-07-08 |