Sara Grace Gibson

NPI #1174120646 in Catoosa, Oklahoma

Provider Information

NPI Number: 1174120646
Entity Type: Individual
Name: Sara Grace Gibson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Oct 7, 2020
Last Updated: Oct 7, 2020

Practice Location

Address: 19320 E ADMIRAL PL STE B
City: Catoosa
State: Oklahoma
ZIP Code: 74015-3240
Phone: (918) 340-5503

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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