Individual
AUTUMN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3711 E SOUTHPORT RD, INDIANAPOLIS, IN 46227-7874
(317) 796-6668
Mailing address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5326
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/03/2016
Last updated
01/08/2020
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