Provider Demographics
NPI:1689405631
Name:EMILY GIBSON PSYCHOLOGICAL & BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:EMILY GIBSON PSYCHOLOGICAL & BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-489-1583
Mailing Address - Street 1:185 CHATEAU DR SW STE 102
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-7415
Mailing Address - Country:US
Mailing Address - Phone:256-489-1583
Mailing Address - Fax:256-489-1595
Practice Address - Street 1:185 CHATEAU DR SW STE 102
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-7415
Practice Address - Country:US
Practice Address - Phone:256-489-1583
Practice Address - Fax:256-489-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty