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General NPI Number Information
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NPI Number | 1689964702
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Entity Type | Organization
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Legal Business Name | T. ANN GIBBONS, PH.D., P.A.
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 4370 S TAMIAMI TRL STE 324
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City | SARASOTA
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State | FL
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Zip | 34231-3412
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Country | US
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Telephone | 941-922-6262
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Fax | 941-925-5899
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Provider Business Mailing Address
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Address Line | 4370 S TAMIAMI TRL STE 324
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City | SARASOTA
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State | FL
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Zip | 34231-3412
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Country | US
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Telephone | 941-922-6262
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Fax | 941-925-5899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. T. ANN GIBBONS
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Credential | PH.D.
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Telephone | 941-922-6262
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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 | PY5092
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License Number State | FL
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