Provider Demographics
NPI:1588749519
Name:FARKAS, GINA RENEE (CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:GINA
Middle Name:RENEE
Last Name:FARKAS
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:RENEE
Other - Last Name:SEYMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC/SLP
Mailing Address - Street 1:8477 S SUNCOAST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-5028
Mailing Address - Country:US
Mailing Address - Phone:800-381-0822
Mailing Address - Fax:352-565-5201
Practice Address - Street 1:6251 STEVENSON OAKS DR
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2783
Practice Address - Country:US
Practice Address - Phone:800-381-0822
Practice Address - Fax:352-565-5201
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1659302-01Medicaid