Individual
MRS. AGNES M GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
126 LAKE AVE, LAKE AVENUE ELEMENTARY SCHOOL, SARATOGA SPRINGS, NY 12866-2431
(518) 584-3678
Mailing address
8 LAURA LN, SARATOGA SPRINGS, NY 12866-8782
(518) 583-6837
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012719-1
NY
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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