Healthcare Provider Details

I. General information

NPI: 1174473516
Provider Name (Legal Business Name): KIMBALA DAWN GABBARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBALA DAWN HAYES

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 4TH ST E
SOUTH POINT OH
45680-9113
US

IV. Provider business mailing address

2727 S 3RD ST
IRONTON OH
45638-2760
US

V. Phone/Fax

Practice location:
  • Phone: 740-534-2100
  • Fax:
Mailing address:
  • Phone: 740-534-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: