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General NPI Number Information
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NPI Number | 1932909785
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Entity Type | Individual
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Provider Name | NIA SIMONE GIBSON RBT
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 12110 HUFFMEISTER RD
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City | CYPRESS
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State | TX
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Zip | 77429-3254
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Country | US
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Telephone | 281-886-7189
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Fax |
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Provider Business Mailing Address
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Address Line | 18108 S PARKVIEW DR APT M14
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City | HOUSTON
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State | TX
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Zip | 77084-6591
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Country | US
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Telephone | 281-414-2166
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-353321
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License Number State | TX
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