Healthcare Provider Details

I. General information

NPI: 1639464233
Provider Name (Legal Business Name): GAYLE ANNE HOBERT CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E MAPLE RD SUITE 120
BIRMINGHAM MI
48009-6408
US

IV. Provider business mailing address

41991 DUXBURY DR
STERLING HEIGHTS MI
48313-3416
US

V. Phone/Fax

Practice location:
  • Phone: 248-792-6414
  • Fax:
Mailing address:
  • Phone: 586-344-6361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: