Karen A Gibson, MS CCC/SLP

Individual provider Active NPI Speech-Language Pathologist · Havre, MT

NPI 1467540799 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1467540799
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
938 (MT)
Practice address
2229 5TH Ave
East Wing Suite 208
Havre, MT 59501-5217
Phone
(406) 945-1328
Fax
(406) 265-2670
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
938MTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 938 MT Yes

Addresses

Primary practice location

2229 5TH Ave
East Wing Suite 208
Havre, MT 59501-5217

Mailing address

21343 Base Rd
Havre, MT 59501-8062
Phone (406) 394-2264

Other identifiers

IdentifierTypeStateIssuer
0532559MedicaidMT

Other providers in Havre, MT

All providers in Havre, MT · Speech-Language Pathologist in Montana

Sources for this page

Verify at the official NPI Registry.