Provider Demographics
NPI:1457773475
Name:SELL-FINLEY, GRETCHEN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:SELL-FINLEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 WOODVALE DR
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-2650
Mailing Address - Country:US
Mailing Address - Phone:916-508-8804
Mailing Address - Fax:
Practice Address - Street 1:2200 TUOLUMNE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2523
Practice Address - Country:US
Practice Address - Phone:707-644-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 19078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist