Provider Demographics
NPI:1548917776
Name:GILMORE, AISHLING CIARA (RBT)
Entity type:Individual
Prefix:MRS
First Name:AISHLING
Middle Name:CIARA
Last Name:GILMORE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 LAUMAN AVE APT US
Mailing Address - Street 2:
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503-1279
Mailing Address - Country:US
Mailing Address - Phone:704-390-4742
Mailing Address - Fax:
Practice Address - Street 1:1032 NW 38TH ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3704
Practice Address - Country:US
Practice Address - Phone:580-699-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRBT-22-206494106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician