Individual
LACI GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2222 S DOBSON RD BLDG 9, MESA, AZ 85202-6481
(602) 926-7200
Mailing address
2222 S DOBSON RD BLDG 9, MESA, AZ 85202-6481
(602) 926-7200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
05/05/2021
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