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General NPI Number Information
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NPI Number | 1114642998
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Entity Type | Individual
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Provider Name | LAURA LEA GIBBS
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Gender | Female
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 15 W 6TH ST
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City | NEWPORT
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State | KY
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Zip | 41071-1833
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Country | US
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Telephone | 513-235-7658
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Fax |
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Provider Business Mailing Address
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Address Line | 10480 JASONS BLF
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City | FLORENCE
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State | KY
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Zip | 41042-3192
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Country | US
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Telephone | 859-802-2353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 134502
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License Number State | KY
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