Individual
AMY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 ARC DR, SAINT AUGUSTINE, FL 32084-0512
(904) 824-7249
Mailing address
2101 ARC DR, SAINT AUGUSTINE, FL 32084-0512
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/07/2017
Last updated
04/07/2017
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