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General NPI Number Information
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NPI Number | 1922788595
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Entity Type | Individual
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Provider Name | KATHERINE FORSYTH GAUSHELL LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 1 CHASE CORPORATE CENTER DR. SUITE 110
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City | HOOVER
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State | AL
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Zip | 35244
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Country | US
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Telephone | 205-905-8497
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Fax |
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Provider Business Mailing Address
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Address Line | 12579 TIEMPO LN
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City | COLLIERVILLE
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State | TN
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Zip | 38017-1109
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Country | US
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Telephone | 901-573-6196
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6252G
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License Number State | AL
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