Basic Information
| Provider Information | |||||||||
| NPI: | 1649584756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILBERT | ||||||||
| FirstName: | SCOTT | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3294 THORNWOOD DR | ||||||||
| Address2: | |||||||||
| City: | BETHEL PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151021550 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3590 WASHINGTON PIKE | ||||||||
| Address2: | |||||||||
| City: | BRIDGEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150171047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122572474 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2010 | ||||||||
| LastUpdateDate: | 07/30/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL010038 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.