Healthcare Provider Details

I. General information

NPI: 1114515202
Provider Name (Legal Business Name): GABRIELLE CHRISTINE PEETERS M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLE CHRISTINE GERMER

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 BEAR CORBITT RD
BEAR DE
19701-1323
US

IV. Provider business mailing address

540 S COLLEGE AVE STE 102
NEWARK DE
19713-1302
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2400
  • Fax:
Mailing address:
  • Phone: 302-831-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO1-0011904
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: