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General NPI Number Information
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NPI Number | 1760170021
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Entity Type | Individual
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Provider Name | GABRIELA VALLEJO
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Gender | Female
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2765 JEFFERSON DAVIS HIGHWAY SUITE 203
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City | STAFFORD
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State | VA
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Zip | 22554
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Country | US
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Telephone | 540-318-8962
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 ENTERPRISE DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-5964
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Country | US
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Telephone |
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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 | 30003720
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202011375
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License Number State | VA
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