Individual
AGATHA LEE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LBA
Contact information
Practice address
32 N 200 W, MORONI, UT 84646-7749
(801) 960-0259
Mailing address
PO BOX 242, MORONI, UT 84646-0242
(801) 960-0259
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11923574-2506
UT
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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