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1336686476
ROBERT GIBSON
PRESCOTT VALLEY, AZ
NPI
1336686476
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ lisac1042)
Enumeration Date
2017-01-27
Last Update Date
2017-01-27
Business Address
-- ROBERT GIBSON
8200 E JACQUE DR
PRESCOTT VALLEY, AZ 86314-6172
Phone number: 928-442-9205
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Mailing Address
-- ROBERT GIBSON
337 ROBINSON DR. UNIT #15
PRESCOTT, AZ 86303
Phone number: 928-910-6864
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