Breanna Gipson

NPI #1831650977 in Crestwood, Illinois

Provider Information

NPI Number: 1831650977
Entity Type: Individual
Name: Breanna Gipson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Mar 29, 2019
Last Updated: Mar 29, 2019

Practice Location

Address: 14045 KILPATRICK AVE
City: Crestwood
State: Illinois
ZIP Code: 60418-2298
Phone: (312) 257-8544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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