Most Relevant Information
Provider Data
| NPI Number: | 1003434036 |
| Provider Name: | STEVEN JAMES GIBBONS RECOVERY COACH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/07/2020 |
| Last Updated: | 07/07/2020 |
Provider Practice Location
85 QUINCY AVE STE B
QUINCY
MA
021696764
Practice Location Phone/Fax
| Phone: | 8579391363 |
| Fax: |
Provider Mailing Location
85 QUINCY AVE STE B
QUINCY
MA
021696764
Provider Mailing Phone/Fax
| Phone: | 8579391363 |
| Fax: |