Individual
KIMBERLY GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5872 W STATE ROAD 16, ROYAL CENTER, IN 46978-9028
(574) 721-1010
Mailing address
5872 W STATE ROAD 16, ROYAL CENTER, IN 46978-9028
(574) 721-1010
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005086A
IN
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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