Provider Demographics
NPI:1003783804
Name:GIBSON, BRIAN CHRISTOPHER (RBT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:GIBSON
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 ANTELOPE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-6102
Mailing Address - Country:US
Mailing Address - Phone:702-482-6707
Mailing Address - Fax:
Practice Address - Street 1:512 ANTELOPE WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-6102
Practice Address - Country:US
Practice Address - Phone:702-482-6707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-25-441814106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician