Individual
KIMBERLY GADULKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
18161 W 13 MILE RD STE E1, SOUTHFIELD, MI 48076-1113
(248) 642-8989
Mailing address
18161 W 13 MILE RD STE E1, SOUTHFIELD, MI 48076-1113
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
7101000951
MI
363A00000X
Physician Assistant
Primary
5601010757
MI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/01/2018
Last updated
07/22/2022
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