Provider Demographics
NPI:1548590326
Name:GIBBS, VARLEISHA D (PHD, OTD, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:VARLEISHA
Middle Name:D
Last Name:GIBBS
Suffix:
Gender:F
Credentials:PHD, OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4512
Mailing Address - Country:US
Mailing Address - Phone:302-494-6007
Mailing Address - Fax:
Practice Address - Street 1:212 CARTER DR STE E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5837
Practice Address - Country:US
Practice Address - Phone:302-494-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00328300225X00000X
DEU1-0001656225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098143U1JMedicare PIN