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1780330910
AUDREY GIBSON
LAKEVILLE, MN
NPI
1780330910
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MN 23282)
Enumeration Date
2022-02-25
Last Update Date
2022-02-25
Business Address
AUDREY GIBSON
17685 JUNIPER PATH STE 303
LAKEVILLE, MN 55044-9821
Phone number: 952-214-8959
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Mailing Address
AUDREY GIBSON
18941 EXCALIBUR TRL
FARMINGTON, MN 55024-7058
Phone number: 651-707-5080
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