Doctor Name: | MRS. AGNES M GAVIN |
NPI Number: | 1063784742 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 012719-1 |
Business Practice Address: | 126 Lake Ave Lake Avenue Elementary School Saratoga Springs, NY - 128662431 |
Business Phone Number: | 5185843678 |
Business Fax Number: | |
Mailing Address: | 8 Laura Ln, SARATOGA SPRINGS |
State: | NY |
Postal Code: | 128668782 |
Phone Number: | 5185836837 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2012 |
NPI Last Update Date: | 01/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 012719-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |