Provider Demographics
NPI:1770663668
Name:GIAMMATTEI, MARIA THERESA (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:THERESA
Last Name:GIAMMATTEI
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6251 PALM TRACE LANDINGS DR APT 209
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1883
Mailing Address - Country:US
Mailing Address - Phone:954-646-7692
Mailing Address - Fax:954-316-7029
Practice Address - Street 1:6251 PALM TRACE LANDINGS DR APT 209
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-1883
Practice Address - Country:US
Practice Address - Phone:954-646-7692
Practice Address - Fax:954-316-7029
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA6928OtherDEPT. OF HEALTH LICENSE