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General NPI Number Information
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NPI Number | 1336192681
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Entity Type | Individual
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Provider Name | DON EUGENE GIBBONS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 703 MILL CREEK RD STE G1
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-3828
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Country | US
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Telephone | 609-494-0009
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Fax | 609-660-2275
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Provider Business Mailing Address
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Address Line | 152 BRIGANTINE RD
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-1308
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Country | US
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Telephone | 609-494-0009
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Fax | 609-660-2275
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35S100351300
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License Number State | NJ
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