Individual
LISA C GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
6003 N ROBINSON AVE, SUITE 103, OKLAHOMA CITY, OK 73118-7425
(405) 314-0953
Mailing address
2102 WHEATON DR, NORMAN, OK 73071-7356
(405) 701-2487
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1436
OK
Other
Enumeration date
03/26/2007
Last updated
03/14/2008
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