Provider Demographics
NPI:1255594602
Name:GIBSON, SHMEKA YURVETTE (BA)
Entity type:Individual
Prefix:
First Name:SHMEKA
Middle Name:YURVETTE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:SHMEKA
Other - Middle Name:YURVETTE
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:5515 SHELBY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7316
Mailing Address - Country:US
Mailing Address - Phone:901-252-7600
Mailing Address - Fax:
Practice Address - Street 1:5515 SHELBY OAKS DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7316
Practice Address - Country:US
Practice Address - Phone:901-252-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor