Individual
GRANT GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4829 E BELTLINE AVE NE STE 310, GRAND RAPIDS, MI 49525-9350
(616) 279-6414
(616) 588-6036
Mailing address
4829 E BELTLINE AVE NE STE 310, GRAND RAPIDS, MI 49525-9350
(616) 279-6414
(616) 588-6036
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/18/2018
Last updated
10/02/2025
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