Doctor Name: | KEVIN MICHAEL GABBERT |
NPI Number: | 1003812827 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW |
License Number: | 05978 |
Business Practice Address: | 300 W Hutchings St Winterset, IA - 502732104 |
Business Phone Number: | 5154623105 |
Business Fax Number: | 5154629265 |
Mailing Address: | 300 W Hutchings St, WINTERSET |
State: | IA |
Postal Code: | 502732104 |
Phone Number: | 5154623105 |
Fax Number: | 5154629265 |
NPI Enumeration Date: | 06/27/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/17/2006 |
NPI Reactivation Date: | 03/27/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 05978 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |