Individual
MARLA LESHELL CONWELL GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 RIDGEWAY RD, MEMPHIS, TN 38119-7445
(901) 830-1363
Mailing address
1469 DEXTER LAKE DR APT 303, CORDOVA, TN 38016-1725
(662) 719-8152
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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