Provider Demographics
NPI:1205550365
Name:GUDIEL-JOSHI, ELMER (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELMER
Middle Name:
Last Name:GUDIEL-JOSHI
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ELMER
Other - Middle Name:
Other - Last Name:GUDIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10712 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-1664
Mailing Address - Country:US
Mailing Address - Phone:914-261-9341
Mailing Address - Fax:
Practice Address - Street 1:4528 PLANK RD STE A2
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-0141
Practice Address - Country:US
Practice Address - Phone:540-841-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist