Individual
ALYSSA NICOLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7905 N MEADOWLARK WAY STE D, COEUR D ALENE, ID 83815-5041
(208) 618-2593
Mailing address
278 OUTBACK LOOP, SPIRIT LAKE, ID 83869-8600
(208) 889-9710
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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