Individual
JASMINE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4870 N LITCHFIELD RD STE 101, LITCHFIELD PARK, AZ 85340-5041
(623) 935-6040
Mailing address
9836 W PIONEER ST, TOLLESON, AZ 85353-8575
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6905
AZ
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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