Individual
KELLE GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2030 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804-5285
(865) 982-3400
(865) 982-3410
Mailing address
9202 SHADY MILL LN, KNOXVILLE, TN 37922-4235
(803) 463-8861
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5337
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q008611
—
TN
Enumeration date
09/17/2014
Last updated
04/09/2018
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