Individual
ALYSSA MAE ROSE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 W JACKSON ST STE B&C, SHELBYVILLE, IN 46176-1295
(317) 512-3063
(317) 663-2947
Mailing address
1800 W 900 S, FLAT ROCK, IN 47234-9773
(317) 512-3063
(317) 663-2947
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48997
IN
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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