Provider Demographics
NPI:1437518255
Name:GOLD, GABRIELLE S (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:GABRIELLE S
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:SARAH
Other - Last Name:GRABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4107 N 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1734
Mailing Address - Country:US
Mailing Address - Phone:516-695-6371
Mailing Address - Fax:
Practice Address - Street 1:4107 N 48TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1734
Practice Address - Country:US
Practice Address - Phone:516-695-6371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025262235Z00000X
FLSA 13526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist