Individual
MS. LISA MARIE GIBSON-PETTIBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(317) 247-8900
(317) 247-8935
Mailing address
11905 GATWICK VIEW DR, FISHERS, IN 46037-4169
(317) 910-7752
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/13/2007
Last updated
09/14/2022
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