Provider Demographics
NPI:1497253082
Name:BASKIN, GABRIELLE (SLP-ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:GABRIELLE
Middle Name:
Last Name:BASKIN
Suffix:
Gender:F
Credentials:SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 DELL LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6611
Mailing Address - Country:US
Mailing Address - Phone:281-202-8079
Mailing Address - Fax:
Practice Address - Street 1:4043 DELL LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6611
Practice Address - Country:US
Practice Address - Phone:281-202-8079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX403892355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant