Individual
JESSICA GIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 WYOMING AVE, WYOMING, PA 18644-1366
(570) 714-2350
Mailing address
311 MAFFETT ST, PLAINS, PA 18705-1018
(570) 793-1497
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000746
PA
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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