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1073161659
GABRIELLE DEFAZIO
MANAKIN SABOT, VA
NPI
1073161659
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
Enumeration Date
2019-08-28
Last Update Date
2019-08-28
Business Address
GABRIELLE DEFAZIO
44 BROAD STREET RD
MANAKIN SABOT, VA 23103-2213
Phone number: 804-784-7090
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Mailing Address
GABRIELLE DEFAZIO
350 NEW FIDELITY CT
GARNER, NC 27529-2665
Phone number: 919-258-2714
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