Provider Demographics
NPI:1194078352
Name:GILBERT, JAIMIE (PHD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:JAIMIE
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PHD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 4TH AVE
Mailing Address - Street 2:SCHOOL OF COMMUNICATIVE DISORDERS
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1909
Mailing Address - Country:US
Mailing Address - Phone:715-346-2095
Mailing Address - Fax:
Practice Address - Street 1:1901 4TH AVE
Practice Address - Street 2:SCHOOL OF COMMUNICATIVE DISORDERS
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1909
Practice Address - Country:US
Practice Address - Phone:715-346-2095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI413156237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter