MEDICARE: MRS. KATHRYN GOBER

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
1	2355S0801X	Speech-Language Assistant	202016	AR

General Provider Information

NPI Number	:	1841911534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHRYN GOBER

Provider Business Mailing Address
First Line	:	2700 N PRICKETT RD STE 2B
Second Line	:
City	:	BRYANT
State	:	AR
Zip	:	72022-7511
Country	:	US
Telephone Number	:	501-213-0594
Fax Number	:

Provider Business Practice Location Address
First Line	:	6311 BASELINE RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72209-4729
Country	:	US
Telephone Number	:	501-565-3855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2022
Last Update Date	:	08/05/2024

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Directions to “ MRS. KATHRYN GOBER ” Practice Location

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