Individual
SHALETA ELAINE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 1ST FLOOR MED INN RM C166A, ANN ARBOR, MI 48109-5816
(734) 936-9420
Mailing address
3621 S STATE STREET, ANN ARBOR, MI 48108
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000648
MI
Other
Enumeration date
07/25/2013
Last updated
02/12/2019
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