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Individual

RAEGAN ELIZABETH GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7051 N PROMONTORY RANCH RD, PARK CITY, UT 84098-4934
(304) 376-0110
Mailing address
7051 NORTH PROMONTORY RANCH ROAD, PARK CITY, UT 84098
(304) 376-0110

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
08/07/2023
Last updated
08/07/2023
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