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General NPI Number Information
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NPI Number | 1053888305
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Entity Type | Organization
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Legal Business Name | GIFT OF THE GAB THERAPY LLC
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 140 REGENT DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3026
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Country | US
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Telephone | 908-692-6726
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Fax | 732-399-9360
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Provider Business Mailing Address
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Address Line | 140 REGENT DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3026
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Country | US
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Telephone | 908-692-6726
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Fax | 732-399-9360
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Authorized Official
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Title or Position | MEMBER
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Name | YEHUDIS BROWN
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Credential | MS CCC-SLP
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Telephone | 908-692-6726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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