Provider Demographics
NPI:1053596551
Name:GIBSON, SHULUNDA KINTA' (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SHULUNDA
Middle Name:KINTA'
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:6575 WEST LOOP S STE 500
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3509
Mailing Address - Country:US
Mailing Address - Phone:713-560-2369
Mailing Address - Fax:281-754-4290
Practice Address - Street 1:6575 WEST LOOP S STE 500
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3509
Practice Address - Country:US
Practice Address - Phone:713-560-2369
Practice Address - Fax:281-754-4290
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX100744235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist