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Individual

KATHY K GATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1304 MORNINGTON DR, INDIANAPOLIS, IN 46239-8608
(317) 693-0649
Mailing address
1304 MORNINGTON DR, INDIANAPOLIS, IN 46239-8608
(317) 693-0649

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
376J00000X
Homemaker
385H00000X
Respite Care
385HR2055X
Child Mental Illness Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
06/02/2018
Last updated
06/02/2018
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