Individual
GINA MARIE MASBAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
13 WOODFORD LN, PALM COAST, FL 32164-7928
(386) 585-0585
Mailing address
13 WOODFORD LN, PALM COAST, FL 32164-7928
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 6579
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887949400
—
FL
Enumeration date
11/16/2006
Last updated
03/17/2018
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