Provider Demographics
NPI:1255164760
Name:GORELIK, SVETLANA
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:GORELIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 KENNETT PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-3052
Mailing Address - Country:US
Mailing Address - Phone:302-651-2690
Mailing Address - Fax:
Practice Address - Street 1:3130 KENNETT PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-3052
Practice Address - Country:US
Practice Address - Phone:302-651-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist