Individual
DAENA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
185 W IMBODEN DR, DECATUR, IL 62521-5251
(217) 233-1425
(217) 233-1777
Mailing address
10 TANAGER DR, DECATUR, IL 62526-2260
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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