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Individual

MR. ELBERT JERRY GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BHRS

Contact information

Practice address
301 NW 63RD ST, OKLAHOMA CITY, OK 73116-7907
(405) 848-2171
(405) 848-2078
Mailing address
301 NW 63RD ST, OKLAHOMA CITY, OK 73116-7907
(405) 848-2171
(405) 848-2078

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
10/17/2011
Last updated
10/17/2011
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