Gabrielle Pecoraro
Individual provider Active NPI Speech-Language Pathologist · Halifax, VA
NPI 1295467017 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1295467017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2204000973 (VA)
- Practice address
- 1030 Mary Bethune St Ste 100
Halifax, VA 24558-3213 - Phone
- (434) 476-2171
- NPI assigned
- Jun 29, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2204000973 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2204000973 | VA | Yes |
Addresses
Primary practice location
1030 Mary Bethune St Ste 100
Halifax, VA 24558-3213
Mailing address
PO Box 1849
Halifax, VA 24558-1849
Other providers in Halifax, VA
- Mental Swellness
- Francis Barnes Mitchell
- Albert Joseph Mungo
- Pathways Youth Services LLC
- Patient Transport Systems, Inc
- Rural Podiatry, LLC
- Shannon N Scearce
- Harvey Abraham Smith
- Strategic Therapy Associates
- Herman Lee Thomas Jr.
All providers in Halifax, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.