Provider Demographics
NPI:1669939682
Name:GIBSON, BARBARA (DTH)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:DTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 GLENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1915
Mailing Address - Country:US
Mailing Address - Phone:954-646-7110
Mailing Address - Fax:954-530-7528
Practice Address - Street 1:450 NE 44TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-1423
Practice Address - Country:US
Practice Address - Phone:954-646-7110
Practice Address - Fax:954-530-7528
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174H00000XOther Service ProvidersHealth Educator