Provider Demographics
NPI:1326262247
Name:GIBSON, DEBRA A (ND)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:A
Last Name:GIBSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:158 DANBURY RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-3227
Mailing Address - Country:US
Mailing Address - Phone:203-431-4443
Mailing Address - Fax:203-431-6664
Practice Address - Street 1:158 DANBURY RD
Practice Address - Street 2:SUITE 8
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-3227
Practice Address - Country:US
Practice Address - Phone:203-431-4443
Practice Address - Fax:203-431-6664
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000110175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath