Individual
MRS. STEPHANIE SAMANTHA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5310 MATT HWY STE 105, CUMMING, GA 30028-8611
(470) 239-4255
Mailing address
6397 LEE HWY, CHATTANOOGA, TN 37421-2564
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007302
GA
Other
Enumeration date
07/14/2019
Last updated
01/24/2022
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