Provider Demographics
NPI:1639464233
Name:HOBERT, GAYLE ANNE (CMT)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:ANNE
Last Name:HOBERT
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41991 DUXBURY DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-3416
Mailing Address - Country:US
Mailing Address - Phone:586-344-6361
Mailing Address - Fax:
Practice Address - Street 1:950 E MAPLE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6408
Practice Address - Country:US
Practice Address - Phone:248-792-6414
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist