Provider Demographics
NPI:1396091633
Name:GASSEL, YANA M (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:M
Last Name:GASSEL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:YANA
Other - Middle Name:M
Other - Last Name:DOLGOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 CANYON LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7789
Mailing Address - Country:US
Mailing Address - Phone:919-247-9347
Mailing Address - Fax:
Practice Address - Street 1:155 BAKER HOUSE TRENT DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-6271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9925235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14060886OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
NC9925OtherNC BOARD OF EXAMINERS FOR AUDIOLOGY AND SPEECH PATHOLOGY