Provider Demographics
NPI:1851912612
Name:GIPSON, SHAYLA M (LMT)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:M
Last Name:GIPSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23116
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-3116
Mailing Address - Country:US
Mailing Address - Phone:406-927-5554
Mailing Address - Fax:406-371-7286
Practice Address - Street 1:711 CENTRAL AVE STE 223
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-5889
Practice Address - Country:US
Practice Address - Phone:406-927-5554
Practice Address - Fax:406-281-8924
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17957225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist