Individual
MADISON ALEXANDRIA GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
402B LEGACY PARK # 402B, RIDGELAND, MS 39157-4315
(769) 233-7154
Mailing address
LEGACY PARK, 402 B, 402 B, RIDGELAND, MS 39157
(769) 233-7154
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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