Individual
MIKALA RENEE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
5472 MAIN ST STE 101, DEL CITY, OK 73115-5524
(405) 622-3699
Mailing address
3520 N VIRGINIA AVE, OKLAHOMA CITY, OK 73118-3012
(405) 919-0327
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2747
OK
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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