Provider Demographics
NPI:1114608023
Name:GILSTON, KAYLIE J
Entity Type:Individual
Prefix:
First Name:KAYLIE
Middle Name:J
Last Name:GILSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MATHEWS LN
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-2819
Mailing Address - Country:US
Mailing Address - Phone:914-584-1223
Mailing Address - Fax:
Practice Address - Street 1:1811 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-948-3546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor