| Doctor Name: | PAUL GIBSON |
| NPI Number: | 1225401938 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 1857584 |
| Business Practice Address: | 17100 E Shea Blvd Suite 225 Fountain Hills, AZ - 852686625 |
| Business Phone Number: | 4808374565 |
| Business Fax Number: | |
| Mailing Address: | 17100 E Shea Blvd, Suite 225 FOUNTAIN HILLS |
| State: | AZ |
| Postal Code: | 852686625 |
| Phone Number: | 4808374565 |
| Fax Number: | |
| NPI Enumeration Date: | 11/03/2015 |
| NPI Last Update Date: | 11/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 1857584 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |