Gibson, Mary L
Gibson, Mary L is an individual health care provider with primary practice located at 2275 E Cooley Dr , Colton CA 92324-6324. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Gibson, Mary L can be contacted via phone (909) 370-1777.Contact Information
Primary practice address
2275 E Cooley Dr
Colton CA 92324-6324
Phone: (909) 370-1777
Fax: (909) 370-1776
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1396955621 |
|---|---|
| LBN Legal business name | Gibson, Mary L |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2007 |
| Last updated | Feb 24th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396955621 | NPPES |
| California | Other | 5709 | SIMON STAFF NUMBER |
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