Lisa Marie Gibson-pettibon LMSW, BSCJ

NPI 1750423059 - Social Worker - 104100000X

NPI Details
NPI 1750423059
Gender Female
Enumeration Date 02/13/2007
Last Updated 11/20/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
5638 PROFESSIONAL CIR
INDIANAPOLIS IN, 46241-5042, US
Phone (317) 247-8900
Fax (317) 247-8935
Business Location
11905 GATWICK VIEW DR
FISHERS IN, 46037-4169, US
Phone (317) 910-7752
Fax
Toxanomy
Taxonomy Code 104100000X
License State Kansas
License Number 5794
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According to our database, Ms. Lisa Marie Gibson-pettibon LMSW, BSCJ NPI is 1750423059, taxonomy code is 104100000X and license number is 5794, license state is located at Kansas. Lisa Marie Gibson-pettibon LMSW, BSCJ physically located at 5638 Professional Cir, Indianapolis IN, 46241-5042. NPI Number Lisa Marie Gibson-pettibon LMSW, BSCJ has the Individual type.

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1750423059 NPI number is provided on an as is basis without warranty of any kind. 1750423059 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Marie Gibson-pettibon LMSW, BSCJ are for informational purposes only.