National Provider Identifier
Janice Lynn Gibala-Broxholm, CCC/LIC
Janice Lynn Gibala-Broxholm, CCC/LIC is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Newark, NY and a listed phone number of (315) 331-2086.
Profile Overview
- NPI
- 1073779989
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- July 30, 2008
- Last Updated
- July 30, 2008
Practice Location
- 848 Peirson Ave
- Newark, NY 14513-9762
Phone: (315) 331-2086
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1073779989
- Entity Type
- Individual
- Last Name
- Gibala-Broxholm
- First Name
- Janice
- Middle Name
- Lynn
- Name Prefix
- Mrs.
- Credential
- CCC/LIC
- Mailing Street Address
- 848 Peirson Ave
- Mailing City
- Newark
- Mailing State
- NY
- Mailing ZIP Code
- 14513-9762
- Mailing Country
- US
- Mailing Phone
- (315) 331-2086
- Practice Street Address
- 848 Peirson Ave
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513-9762
- Practice Country
- US
- Practice Phone
- (315) 331-2086
- Enumeration Date
- July 30, 2008
- Last Updated
- July 30, 2008
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)