Provider Demographics
NPI:1982777199
Name:GABBERT, SONYA ELIZABETH (PT)
Entity type:Individual
Prefix:MS
First Name:SONYA
Middle Name:ELIZABETH
Last Name:GABBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WASHINGTON COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-5765
Mailing Address - Country:US
Mailing Address - Phone:502-641-0494
Mailing Address - Fax:
Practice Address - Street 1:2222 SULLIVAN TRL
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-7958
Practice Address - Country:US
Practice Address - Phone:352-283-0976
Practice Address - Fax:888-388-8764
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0980505Medicare ID - Type Unspecified