Individual provider · NPI-1
Jakira Gibson
Behavior Technician · Farmington Hills, MI
NPI number1174068845
StatusActive
Last updated in NPPESAug 1, 2022
Details
- NPI
- 1174068845
- Entity type
- Individual (NPI-1)
- Name
- Jakira Gibson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2017
- Certification date
- Aug 1, 2022
- Last updated
- Aug 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
| 175T00000X | Peer Specialist | g 125 364 089 065 | MI |
Practice location
27777 Inkster RdFarmington Hills, MI 48334-5310
Phone 248-238-8126
Mailing address
27777 Inkster RdFarmington Hills, MI 48334-5310
Phone 248-238-8126
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.