| Doctor Name: | DR. REX CLIFTON GARDNER |
| NPI Number: | 1043378375 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., PHD |
| License Number: | |
| Business Practice Address: | 1107 Belle View Blvd Apt B1 Alexandria, VA - 223076629 |
| Business Phone Number: | 2027391380 |
| Business Fax Number: | |
| Mailing Address: | 1070 S La Brea Ave, LOS ANGELES |
| State: | CA |
| Postal Code: | 900196905 |
| Phone Number: | 2134573387 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 05/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |