Provider Demographics
NPI:1023653425
Name:GIBBERMAN, ARIEL (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:GIBBERMAN
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 1:1201 S EADS ST APT 808
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2840
Mailing Address - Country:US
Mailing Address - Phone:703-964-6522
Mailing Address - Fax:
Practice Address - Street 1:1201 S EADS ST APT 808
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-2840
Practice Address - Country:US
Practice Address - Phone:703-964-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-10
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2204000374OtherPROVISIONAL SPEECH-LANGUAGE PATHOLOGIST LICENSE