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General NPI Number Information
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NPI Number | 1275230997
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Entity Type | Individual
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Provider Name | EMILY JANE GIBBS LAMFT
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 202 N CEDAR AVE STE 1
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City | OWATONNA
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State | MN
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Zip | 55060-2306
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Country | US
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Telephone | 612-382-9587
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18658
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City | MINNEAPOLIS
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State | MN
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Zip | 55418-0658
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Country | US
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Telephone | 206-265-3112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4394
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License Number State | MN
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