Individual
MRS. IESHA RENEE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AMFT
Contact information
Practice address
826 N 100 E STE 1A, SPANISH FORK, UT 84660-1241
(801) 901-2223
Mailing address
826 N 100 E STE 1A, SPANISH FORK, UT 84660-1241
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
10493287-3904
UT
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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