Individual
ALEXANDER TYRELL GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50194 SCHOENHERR RD, SHELBY TOWNSHIP, MI 48315-3136
(586) 991-6596
Mailing address
50194 SCHOENHERR RD, SHELBY TOWNSHIP, MI 48315-3136
(586) 991-6596
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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