Provider Demographics
NPI:1679677090
Name:GIBBINGS, ELISABETH NICHOLAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:NICHOLAS
Last Name:GIBBINGS
Suffix:
Gender:F
Credentials:PSYD
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Other - First Name:
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Mailing Address - Street 1:1 UNIVERSITY PL
Mailing Address - Street 2:WIDENER UNIVERSITY
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5792
Mailing Address - Country:US
Mailing Address - Phone:610-499-1221
Mailing Address - Fax:610-499-4625
Practice Address - Street 1:1 UNIVERSITY PL
Practice Address - Street 2:WIDENER UNIVERSITY
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5700
Practice Address - Country:US
Practice Address - Phone:610-499-1221
Practice Address - Fax:610-499-4625
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPS005785L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical