Individual
MRS. LORA REBECCA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3380
AR
225XP0200X
Pediatric Occupational Therapist
3892
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4225538
BCBS OF TN PIN
TN
01
—
4289409
BCBS
TN
Enumeration date
08/19/2008
Last updated
02/01/2023
Update your record
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