Provider Demographics
NPI:1790647717
Name:GIFT OF GAB SPEECH THERAPY, LLC
Entity type:Organization
Organization Name:GIFT OF GAB SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP, CAS
Authorized Official - Phone:973-405-3927
Mailing Address - Street 1:PO BOX 875299
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-5299
Mailing Address - Country:US
Mailing Address - Phone:973-405-3927
Mailing Address - Fax:
Practice Address - Street 1:8032 W AURORA HEIGHTS LOOP
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:973-405-3927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-28
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty