Provider Demographics
NPI:1578970125
Name:GABLE, KRISI
Entity Type:Individual
Prefix:MRS
First Name:KRISI
Middle Name:
Last Name:GABLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KRISTINA
Other - Middle Name:DOCKERY
Other - Last Name:GABLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:146 SUMMIT VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-5932
Mailing Address - Country:US
Mailing Address - Phone:501-658-3560
Mailing Address - Fax:
Practice Address - Street 1:2024 ARKANSAS VALLEY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4166
Practice Address - Country:US
Practice Address - Phone:501-944-5968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist