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General NPI Number Information
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NPI Number | 1316703085
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Entity Type | Organization
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Legal Business Name | GIBSON FAMILY THERAPY INC
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 5588 N PALM AVE STE 1
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City | FRESNO
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State | CA
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Zip | 93704-1913
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Country | US
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Telephone | 559-492-6635
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Fax |
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Provider Business Mailing Address
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Address Line | 5588 N PALM AVE STE 1
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City | FRESNO
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State | CA
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Zip | 93704-1913
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Country | US
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Telephone | 559-492-6635
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BARRETT GIBSON
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Credential | AMFT
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Telephone | 559-492-6635
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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 |
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License Number State |
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