Provider Demographics
NPI:1598913550
Name:TOTTEN, GAIL GOODRICH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:GOODRICH
Last Name:TOTTEN
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 1:4930 TRAIL WEST DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6442
Mailing Address - Country:US
Mailing Address - Phone:512-470-0451
Mailing Address - Fax:
Practice Address - Street 1:5766 BALCONES DR
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4254
Practice Address - Country:US
Practice Address - Phone:512-480-9573
Practice Address - Fax:512-458-9573
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist