Provider Demographics
NPI:1518252006
Name:GADBOIS, JOAN CAROL
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:CAROL
Last Name:GADBOIS
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 1:2213 S DARTMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-0559
Mailing Address - Country:US
Mailing Address - Phone:605-361-7889
Mailing Address - Fax:
Practice Address - Street 1:2213 S DARTMOOR AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-0559
Practice Address - Country:US
Practice Address - Phone:605-361-7889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0009225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics