Samuel Gibson

NPI #1386446763 in Provo, Utah

Provider Information

NPI Number: 1386446763
Entity Type: Individual
Name: Samuel Gibson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 26, 2025
Last Updated: Mar 26, 2025

Practice Location

Address: 585 LAKEVIEW PKWY BDLG 6
City: Provo
State: Utah
ZIP Code: 84606
Phone: (801) 935-4171

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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