Provider Demographics
NPI:1427783620
Name:GAMBINO, NATALIE MICHEL (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:MICHEL
Last Name:GAMBINO
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 1:220 PHILLY CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-0527
Mailing Address - Country:US
Mailing Address - Phone:985-515-6680
Mailing Address - Fax:
Practice Address - Street 1:220 PHILLY CT
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-0527
Practice Address - Country:US
Practice Address - Phone:985-515-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2662503Medicaid