Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103K00000X | Behavior Analyst | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1780028605 |
---|---|
Provider Name | Ms. Veronica Gibson |
First Address | Las Vegas, NV 89147 |
Second Address | Las Vegas, NV 89147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2013 |
Last Update Date | 26/04/2013 |