Healthcare Provider Details

I. General information

NPI: 1770735805
Provider Name (Legal Business Name): MARGIE GILBERTSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SEGOVIA DR
HOT SPRINGS VILLAGE AR
71909-2643
US

IV. Provider business mailing address

31 SEGOVIA DR
HOT SPRINGS VILLAGE AR
71909-2643
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-4342
  • Fax:
Mailing address:
  • Phone: 501-922-4342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-107
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP680
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: