Provider Demographics
NPI:1497274088
Name:JATENE, GABRIELA ANDREA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ANDREA
Last Name:JATENE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 K ST NW APT 306
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2960
Mailing Address - Country:US
Mailing Address - Phone:862-266-5566
Mailing Address - Fax:
Practice Address - Street 1:450 K STREET NW
Practice Address - Street 2:APT 306
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001
Practice Address - Country:US
Practice Address - Phone:862-266-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC001191235Z00000X
VA2202008385235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14147190OtherSPEECH-LANGUAGE PATHOLOGY