Individual
ELISE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
19167 SUNSET ST, DETROIT, MI 48234-2047
(248) 917-2751
Mailing address
19167 SUNSET ST, DETROIT, MI 48234-2047
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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