Individual
GABRIELLE EDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 VONDERBURG DR STE 201, BRANDON, FL 33511-5900
(813) 653-1149
Mailing address
8731 SERENE RETREAT LN APT 312, TAMPA, FL 33619-7350
(954) 850-7740
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22028
FL
390200000X
Student in an Organized Health Care Education/Training Program
SZ11006
FL
Other
Enumeration date
09/20/2022
Last updated
10/06/2023
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