| NPI | 1487041208 |
|---|---|
| Former Name | SHELLEY ANN GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-15-18242) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2018-07-19 |