Provider Demographics
NPI:1003218702
Name:GILBERT, KATHRYN
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:STREBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6705 WHITE HORSE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-2503
Mailing Address - Country:US
Mailing Address - Phone:704-654-8599
Mailing Address - Fax:980-938-6088
Practice Address - Street 1:6705 WHITE HORSE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-2503
Practice Address - Country:US
Practice Address - Phone:704-654-8599
Practice Address - Fax:980-938-6088
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA 84882355S0801X
UT1-22-61700103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant