| Doctor Name: | MRS. LAQUITA RENEE GARDNER |
| NPI Number: | 1437373354 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MCD, CCC-SLP |
| License Number: | S3016 |
| Business Practice Address: | 120 Beckrich Rd Suite 130 Panama City Beach, FL - 324072521 |
| Business Phone Number: | 8502356360 |
| Business Fax Number: | |
| Mailing Address: | 201 Chelsea Dr, PANAMA CITY BEACH |
| State: | FL |
| Postal Code: | 324131406 |
| Phone Number: | 3185481517 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 07/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | S3016 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| 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 |