Provider Demographics
NPI:1063177541
Name:GILKS, CINDY BETH
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:BETH
Last Name:GILKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEREDITH RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4249
Mailing Address - Country:US
Mailing Address - Phone:603-479-9453
Mailing Address - Fax:
Practice Address - Street 1:5 PINKERTON ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1515
Practice Address - Country:US
Practice Address - Phone:603-479-9453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH87382103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool