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NPI Code Detail

MEDICARE: GISELA HORNBERGER MS, CCC-SLP

MEDICARE: GISELA HORNBERGER MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2202005752VA

General Provider Information

NPI Number : 1285474742
Entity Type Code : Individual
Provider Name (Legal Business Name) : GISELA HORNBERGER MS, CCC-SLP
Provider Business Mailing Address
First Line : 3813 FISH POND LN
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-5947
Country : US
Telephone Number : 804-484-5231
Fax Number :
Provider Business Practice Location Address
First Line : 2420 PEMBERTON RD
Second Line :
City : RICHMOND
State : VA
Zip : 23233-2003
Country : US
Telephone Number : 804-747-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2024
Last Update Date : 05/30/2024

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