Provider Demographics
NPI:1073669388
Name:GERVAIS, ALAINE JOYCE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALAINE
Middle Name:JOYCE
Last Name:GERVAIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:13844 ELIOT AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7543
Mailing Address - Country:US
Mailing Address - Phone:407-361-5429
Mailing Address - Fax:321-281-4942
Practice Address - Street 1:11602 LAKE UNDERHILL RD STE 129
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4460
Practice Address - Country:US
Practice Address - Phone:407-277-5400
Practice Address - Fax:321-281-4942
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSA9774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist