Provider Demographics
NPI:1730207929
Name:GAMMI, ALI VAEZ (CCCSLP)
Entity type:Individual
Prefix:MR
First Name:ALI
Middle Name:VAEZ
Last Name:GAMMI
Suffix:
Gender:
Credentials:CCCSLP
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:VAEZGHAEMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16905 HORN POINT DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2085
Mailing Address - Country:US
Mailing Address - Phone:301-525-5553
Mailing Address - Fax:
Practice Address - Street 1:333 MILL ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6473
Practice Address - Country:US
Practice Address - Phone:301-665-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist