| NPI | 1609145986 |
|---|---|
| Former Name | KEVIN GIBBS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |