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General NPI Number Information
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NPI Number | 1679907596
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Entity Type | Individual
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Provider Name | VIRGINIA B. GAUSDEN M.S.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 14605 E LARKSPUR DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-2105
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Country | US
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Telephone | 480-353-9975
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Fax |
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Provider Business Mailing Address
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Address Line | 14605 E LARKSPUR DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-2105
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Country | US
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Telephone | 480-353-9975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SLP8312
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License Number State | AZ
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