Individual
KELSI GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13821 TECHNOLOGY DR UNIT A1, OKLAHOMA CITY, OK 73134-1045
(539) 777-0940
Mailing address
816 LAKESIDE CIR # CIT, EDMOND, OK 73012-6635
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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