Provider Demographics
NPI:1306123609
Name:SYFERT, GRETCHEN LEE ADAMS (AUD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:LEE ADAMS
Last Name:SYFERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 NEWFOUND HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-2869
Mailing Address - Country:US
Mailing Address - Phone:321-459-2257
Mailing Address - Fax:321-459-2257
Practice Address - Street 1:2542 NEWFOUND HARBOR DR
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-2869
Practice Address - Country:US
Practice Address - Phone:321-459-2257
Practice Address - Fax:321-459-2257
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1605231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist