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NPI Code Detail

MEDICARE: MR. PETER GIBBS LMFT

MEDICARE: MR. PETER GIBBS LMFT
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
1106H00000XMarriage & Family Therapist24MA

General Provider Information

NPI Number : 1710155635
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PETER GIBBS LMFT
Provider Business Mailing Address
First Line : 1900 W PARK DR
Second Line : SUITE 280
City : WESTBOROUGH
State : MA
Zip : 01581-3942
Country : US
Telephone Number : 508-983-1400
Fax Number :
Provider Business Practice Location Address
First Line : 1900 W PARK DR
Second Line : SUITE 280
City : WESTBOROUGH
State : MA
Zip : 01581-3942
Country : US
Telephone Number : 508-983-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2008
Last Update Date : 02/13/2008

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