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NPI Code Detail

MEDICARE: CHRISTA GIBBS KOLB SLP

MEDICARE: CHRISTA GIBBS KOLB SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist005684GA

General Provider Information

NPI Number : 1114106705
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTA GIBBS KOLB SLP
Provider Business Mailing Address
First Line : PO BOX 28528
Second Line :
City : ATLANTA
State : GA
Zip : 30358-0528
Country : US
Telephone Number : 404-247-7959
Fax Number : 404-459-6566
Provider Business Practice Location Address
First Line : 1123 OXFORD CRES NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-1624
Country : US
Telephone Number : 404-247-7959
Fax Number : 404-459-6566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2007
Last Update Date : 10/30/2007

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Directions to “ CHRISTA GIBBS KOLB SLP” Practice Location

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