Individual
CRYSTAL GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
33730 RYAN RD, STERLING HEIGHTS, MI 48310-6302
(248) 830-7541
Mailing address
33730 RYAN RD, STERLING HEIGHTS, MI 48310-6302
(248) 830-7541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015538
MI
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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