Individual
DR. LENWOOD GIBSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, BCBA-D, LBA
Contact information
Practice address
104 CHENANGO DR, BAY SHORE, NY 11706-3720
(508) 579-3068
Mailing address
104 CHENANGO DR, BAY SHORE, NY 11706-3720
(508) 579-3068
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001113
NY
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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