| NPI | 1295244838 |
|---|---|
| Former Name | CARSON MARIE GIBBONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.172861) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2021-06-14 |