Individual
MISS MEAGAN GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
9940 GA 92, WOODSTOCK, GA 30188
(470) 361-2000
Mailing address
399 SHADY BROOK DR, CANTON, GA 30114-8582
(404) 493-1040
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46239
GA
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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