Individual
TRACEY LEE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
605 MENA ST, MENA, AR 71953-3339
(479) 385-1236
Mailing address
2356 N 9TH ST, DE QUEEN, AR 71832-9262
(870) 784-3285
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2021-017
AR
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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