Provider Demographics
NPI:1396540126
Name:ROSENBERG, GINA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 WINGFIELD HILLS RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7234
Mailing Address - Country:US
Mailing Address - Phone:775-773-6656
Mailing Address - Fax:
Practice Address - Street 1:2360 WINGFIELD HILLS RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7234
Practice Address - Country:US
Practice Address - Phone:775-773-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist