Provider Demographics
NPI:1942521083
Name:GEMBERLING, AUDREY LOUISE (MA)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:LOUISE
Last Name:GEMBERLING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 SEQUOIA ST
Mailing Address - Street 2:
Mailing Address - City:BAREFOOT BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32976-7323
Mailing Address - Country:US
Mailing Address - Phone:321-514-7052
Mailing Address - Fax:
Practice Address - Street 1:907 SEQUOIA ST
Practice Address - Street 2:
Practice Address - City:BAREFOOT BAY
Practice Address - State:FL
Practice Address - Zip Code:32976-7323
Practice Address - Country:US
Practice Address - Phone:321-514-7052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor