Individual
AMBER GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
4624 SUMMERDALE DR, MILTON, FL 32571-1368
(850) 994-3456
Mailing address
4624 SUMMERDALE DR, MILTON, FL 32571-1368
(850) 994-3456
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5294
SC
Other
Enumeration date
12/19/2013
Last updated
05/23/2019
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