Basic Information
| Provider Information | |||||||||
| NPI: | 1962721522 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILBERT | ||||||||
| FirstName: | DARLENE | ||||||||
| MiddleName: | MARIE BRADLEY | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1815 S VERA CREST DR | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 990379083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025345894 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 414 S UNIVERSITY RD | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992065555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099244650 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2010 | ||||||||
| LastUpdateDate: | 10/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SLP006574 | GA | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | LL60193944 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.