Individual
ALEXA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16593 ZENDA ST, VICTORVILLE, CA 92395-3975
(909) 329-7895
Mailing address
PO BOX 205, VICTORVILLE, CA 92393-0205
(909) 329-7895
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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