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General NPI Number Information
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NPI Number | 1790647717
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Entity Type | Organization
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Legal Business Name | GIFT OF GAB SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 11/28/2025
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 8032 W AURORA HEIGHTS LOOP
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City | WASILLA
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State | AK
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Zip | 99654
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Country | US
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Telephone | 973-405-3927
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 875299
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City | WASILLA
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State | AK
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Zip | 99687-5299
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Country | US
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Telephone | 973-405-3927
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MICHAEL OLIVEIRA
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Credential | MS CCC-SLP, CAS
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Telephone | 973-405-3927
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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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