| NPI | 1194427872 |
|---|---|
| Former Name | MARTHA GIBBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5017881) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC ESEH-Q3N09) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2025-01-21 |