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NPI Code Detail

MEDICARE: GRETCHEN SELL-FINLEY MS CCC-SLP

MEDICARE: GRETCHEN SELL-FINLEY MS CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSP 19078CA

General Provider Information

NPI Number : 1457773475
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETCHEN SELL-FINLEY MS CCC-SLP
Provider Business Mailing Address
First Line : 940 WOODVALE DR
Second Line :
City : DIXON
State : CA
Zip : 95620-2650
Country : US
Telephone Number : 916-508-8804
Fax Number :
Provider Business Practice Location Address
First Line : 2200 TUOLUMNE ST
Second Line :
City : VALLEJO
State : CA
Zip : 94589-2523
Country : US
Telephone Number : 707-644-7401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2014
Last Update Date : 01/10/2014

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