Individual
SHALYIA GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2865 NE SANDY BLVD APT 429, PORTLAND, OR 97232-3642
(213) 393-5118
Mailing address
2865 NE SANDY BLVD APT 429, PORTLAND, OR 97232-3642
(213) 393-5118
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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