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Reginald Gibbs, LPC LICENSE

Individual provider Active NPI Assistant Behavior Analyst · Atmore, AL

NPI 1710690482 · NPPES record last updated Dec 27, 2022

Key facts

NPI
1710690482
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
License
RSE1138 (AL)
Practice address
150 Patterson St
Atmore, AL 36502-1818
Phone
(251) 359-6459
NPI assigned
Dec 27, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RSE1138ALMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Latisha Dailey LLC Current
since Jan 1, 2023		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X RSE1138 AL Yes

Addresses

Primary practice location

150 Patterson St
Atmore, AL 36502-1818

Mailing address

150 Patterson St
Atmore, AL 36502-1818
Phone (251) 359-6459

Other names

  • Miss Latisha Dailey Former name

Other providers in Atmore, AL

All providers in Atmore, AL · Assistant Behavior Analyst in Alabama

Sources for this page

Verify at the official NPI Registry.