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Individual
MRS. ROENA FAYE GABBARD
Active
Individual
MRS. ROENA FAYE GABBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KYR0715
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1485
FIRST STEPS PROVIDER
KY
05
—
GO-200
—
KY
Enumeration date
09/13/2006
Last updated
07/09/2007
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