MEDICARE: PAIGE DANIELLE GONZALEZ M.S., 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
1	235Z00000X	Speech-Language Pathologist	119825	TX

General Provider Information

NPI Number	:	1487350997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE DANIELLE GONZALEZ M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2494 FM 2663
Second Line	:
City	:	CROCKETT
State	:	TX
Zip	:	75835-6195
Country	:	US
Telephone Number	:	936-222-7128
Fax Number	:

Provider Business Practice Location Address
First Line	:	2494 FM 2663
Second Line	:
City	:	CROCKETT
State	:	TX
Zip	:	75835-6195
Country	:	US
Telephone Number	:	936-222-7128
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	02/04/2026

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Directions to “ PAIGE DANIELLE GONZALEZ M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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