Doctor Name: | CAROL BETH GUSTAFSON |
NPI Number: | 1043220973 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 16844 |
Business Practice Address: | 2002 Holcombe Blvd Rm 2a-120 Houston, TX - 770304211 |
Business Phone Number: | 7137947112 |
Business Fax Number: | |
Mailing Address: | 2002 Holcombe Blvd, Rm 2a-120 HOUSTON |
State: | TX |
Postal Code: | 770304211 |
Phone Number: | 7137947112 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 16844 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |