Individual
EMILY ALYSE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2050 W ILES AVE, SPRINGFIELD, IL 62704-4181
(217) 487-0722
Mailing address
3804 BLUESTEM CT, SPRINGFIELD, IL 62712-8780
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.023062
IL
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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