Basic Information
Provider Information
NPI: 1376918946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GILSON
FirstName: CARALINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MOT, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3703 COUNTY ROAD 92
Address2:  
City: LINDSEY
State: OH
PostalCode: 434429754
CountryCode: US
TelephoneNumber: 4196800992
FaxNumber:  
Practice Location
Address1: 2701 CHESTNUT STATION CT
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402996395
CountryCode: US
TelephoneNumber: 8003551060
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/08/2015
LastUpdateDate: 12/08/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT.009090OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home