Provider Demographics
NPI:1831456565
Name:GOBER, ALLISON LEIGH (RM, CPM)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LEIGH
Last Name:GOBER
Suffix:
Gender:F
Credentials:RM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 1/2 W 3RD ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-2041
Mailing Address - Country:US
Mailing Address - Phone:719-221-3937
Mailing Address - Fax:719-452-3937
Practice Address - Street 1:129 1/2 W 3RD ST
Practice Address - Street 2:SUITE 8
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2041
Practice Address - Country:US
Practice Address - Phone:719-221-3937
Practice Address - Fax:719-452-3937
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMWR-135176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife