Individual
MICHELLE RENE' GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
225 SAINT JOHN RD, ELIZABETHTOWN, KY 42701-2918
(270) 769-3314
Mailing address
116 CREEKVIEW LN, RINEYVILLE, KY 40162-9513
(270) 735-6839
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003697A
IN
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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