Individual
GINA WERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
30 N SAN PEDRO RD, STE. 265, SAN RAFAEL, CA 94903-4118
(415) 479-7880
Mailing address
120 FLORIBEL AVE, SAN ANSELMO, CA 94960-2215
(831) 818-2308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15847
CA
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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