Provider Demographics
NPI:1902651367
Name:VAYSMAN, GABRIELLA JENNIFER (CF-SLP)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:JENNIFER
Last Name:VAYSMAN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:GABRIELLA
Other - Middle Name:JENNIDER
Other - Last Name:VAYSMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CF-SLP
Mailing Address - Street 1:19380 COLLINS AVE APT 914
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2276
Mailing Address - Country:US
Mailing Address - Phone:732-881-1426
Mailing Address - Fax:
Practice Address - Street 1:17971 BISCAYNE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2531
Practice Address - Country:US
Practice Address - Phone:305-749-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist