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General NPI Number Information
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NPI Number | 1699873562
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Entity Type | Organization
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Legal Business Name | GAIL M VAN TATENHOVE, PA
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 8322 TANGELO TREE DR
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City | ORLANDO
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State | FL
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Zip | 32836-5437
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Country | US
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Telephone | 407-876-3423
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Fax | 407-876-2120
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Provider Business Mailing Address
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Address Line | 8322 TANGELO TREE DR
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City | ORLANDO
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State | FL
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Zip | 32836-5437
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Country | US
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Telephone | 407-876-3423
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Fax | 407-876-2120
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GAIL M VAN TATENHOVE
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Credential | MS, CCC-SLP, PA
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Telephone | 407-876-3423
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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 | SA318
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License Number State | FL
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