Healthcare Provider Details

I. General information

NPI: 1245720333
Provider Name (Legal Business Name): STEPHANIE GABLE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N GRAND AVE STE 101
FORT THOMAS KY
41075-1765
US

IV. Provider business mailing address

40 N GRAND AVE STE 101
FORT THOMAS KY
41075-1765
US

V. Phone/Fax

Practice location:
  • Phone: 859-781-4900
  • Fax: 859-781-3039
Mailing address:
  • Phone: 859-781-4900
  • Fax: 859-572-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.02125
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: