Individual
KENNETH GILMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5219 GUADALUPE TRL NW, ALBUQUERQUE, NM 87107-3346
(505) 980-1865
Mailing address
4801 LANG AVE NE, SUITE 110, ALBUQUERQUE, NM 87109-4475
(505) 980-1865
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0837
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46181334
—
NM
Enumeration date
12/01/2006
Last updated
07/09/2007
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