Individual
MRS. BRENDA L GASTECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP/L
Contact information
Practice address
11050 W PLEASANT ST, CORRY, PA 16407-8818
(814) 664-2622
(814) 664-2622
Mailing address
11050 W PLEASANT ST, CORRY, PA 16407-8818
(814) 664-2622
(814) 664-2622
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
013600
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02319991
—
NY
Enumeration date
07/27/2006
Last updated
03/12/2013
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