Individual
CARLISSA GIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21025 N 8TH WAY, PHOENIX, AZ 85024-4204
(602) 888-8787
Mailing address
21025 N 8TH WAY, PHOENIX, AZ 85024-4204
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
25-414653
AZ
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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