Individual
DR. KELLY JOAN CARLSON GIBAS
Active
Individual
DR. KELLY JOAN CARLSON GIBAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DBH
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
CC01539
MN
133NN1002X
Nutrition Education Nutritionist
—
MN
174H00000X
Health Educator
—
MN
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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