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NPI Code Detail

MEDICARE: DANA GIBSON

MEDICARE: DANA GIBSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1003153727
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA GIBSON
Provider Business Mailing Address
First Line : 4401 BELLE OAKS DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-8537
Country : US
Telephone Number : 866-571-2700
Fax Number :
Provider Business Practice Location Address
First Line : 4401 BELLE OAKS DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-8537
Country : US
Telephone Number : 866-571-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2013
Last Update Date : 01/15/2013

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Directions to “ DANA GIBSON ” Practice Location

Language Start Address Practice Location
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