Individual
MS. JESSICA ELIZABETH GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1600 RIVERFRONT DR, LITTLE ROCK, AR 72202
(501) 663-6965
(501) 603-0675
Mailing address
24 AVIGNON CT, LITTLE ROCK, AR 72223-9104
(501) 351-5127
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#2586
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113694335
TRICARE
AR
05
—
168616721
—
AR
Enumeration date
04/29/2008
Last updated
09/25/2008
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