Individual
ANN GIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1816 MCGEE AVE, NORTHLAKE, TX 76226-1578
(817) 789-9480
Mailing address
1816 MCGEE AVE, NORTHLAKE, TX 76226-1578
(817) 789-9480
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111137
TX
Other
Enumeration date
06/25/2015
Last updated
12/10/2019
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