Individual
MS. CRYSTAL GABHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
106 DIECKS DR, ELIZABETHTOWN, KY 42701-2443
(270) 769-0058
Mailing address
106 DIECKS DR, ELIZABETHTOWN, KY 42701-2443
(270) 769-0058
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368429
ANTHEM NUMBER
KY
Enumeration date
04/10/2007
Last updated
07/08/2007
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