Individual
ASHLEY GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 N WHEELER AVE, SALLISAW, OK 74955-2227
(918) 775-5513
Mailing address
1108 N WHEELER AVE, SALLISAW, OK 74955-2227
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1902791957
OK
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/10/2025
Last updated
06/12/2025
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