Individual
MS. GAIL MARGIE VANTATENHOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA, MS, CCC-SLP
Contact information
Practice address
8322 TANGELO TREE DR, ORLANDO, FL 32836-5437
(407) 876-3423
(407) 876-2120
Mailing address
8322 TANGELO TREE DR, ORLANDO, FL 32836-5437
(407) 876-3423
(407) 876-2120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA318
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
671119796
MEDICAID WAIVER
FL
05
—
886506000
—
FL
Enumeration date
05/03/2006
Last updated
04/24/2008
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