Provider Demographics
NPI:1326205121
Name:GILBAUGH, PATRICIA CAROLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:CAROLYN
Last Name:GILBAUGH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:CAROLYN
Other - Last Name:MCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:VAN HORNE
Mailing Address - State:IA
Mailing Address - Zip Code:52346-0004
Mailing Address - Country:US
Mailing Address - Phone:319-361-6529
Mailing Address - Fax:319-343-1059
Practice Address - Street 1:3726 QUEEN CT SW STE 105
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-3903
Practice Address - Country:US
Practice Address - Phone:319-361-6529
Practice Address - Fax:319-343-1059
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06342104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker