Most Relevant Information
Provider Data
| NPI Number: | 1003180340 |
| Provider Name: | CONNIE FRANCIS GIBSON |
| Entity Type: | Individual |
| Taxonomy Code: | 103TB0200X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/05/2012 |
| Last Updated: | 03/05/2012 |
Provider Practice Location
10313 SW 69TH AVE
TIGARD
OR
972239103
Practice Location Phone/Fax
| Phone: | 5037263740 |
| Fax: | 5037263741 |
Provider Mailing Location
10313 SW 69TH AVE
TIGARD
OR
972239103
Provider Mailing Phone/Fax
| Phone: | 5037263740 |
| Fax: | 5037263741 |