Provider Demographics
NPI:1508095514
Name:GERLICHER, NOELA K (SLP,MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:NOELA
Middle Name:K
Last Name:GERLICHER
Suffix:
Gender:F
Credentials:SLP,MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20864 TUMALO RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-8447
Mailing Address - Country:US
Mailing Address - Phone:541-389-9377
Mailing Address - Fax:
Practice Address - Street 1:20864 TUMALO RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-8447
Practice Address - Country:US
Practice Address - Phone:541-389-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-11
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR11232OtherBORD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY