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Individual

BIANCA ELLIE GIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
740 E GENERAL STEWART WAY STE 202B, HINESVILLE, GA 31313-2630
(912) 294-4055
(866) 467-4321
Mailing address
740 E GENERAL STEWART WAY STE 202B, HINESVILLE, GA 31313-2630
(912) 294-4055
(866) 467-4321

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-134026
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-20-134026
BACB
GA
Enumeration date
09/09/2020
Last updated
09/09/2020
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