Individual
MADISON GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202-4703
(205) 940-1112
Mailing address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202-4703
(205) 940-1112
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4171175
—
Other
Enumeration date
01/10/2026
Last updated
01/10/2026
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