Individual
GABRIELLA DIDOMENICO VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
802 W PARK AVE, SUITE 211, OCEAN, NJ 07712-8527
(732) 918-4848
Mailing address
145 BIRCH AVE, LITTLE SILVER, NJ 07739-1148
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00616100
NJ
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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