Individual
MIRANDA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2846 N GARLAND AVE, FAYETTEVILLE, AR 72704-2164
(479) 439-6906
(833) 645-0881
Mailing address
195 W LAFAYETTE ST APT 2, FAYETTEVILLE, AR 72701-4399
(479) 409-3274
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48992
AR
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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