1922346881 NPI number — MS. GAIL CZARNECKI FAITHFUL M.A.

Table of content: MS. GAIL CZARNECKI FAITHFUL M.A. (NPI 1922346881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922346881 NPI number — MS. GAIL CZARNECKI FAITHFUL M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FAITHFUL
Provider First Name:
GAIL
Provider Middle Name:
CZARNECKI
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EHLERS
Provider Other First Name:
GAIL
Provider Other Middle Name:
CZARNECKI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A., CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922346881
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9325 LONG CREEK FAIRWAY DR
Provider Second Line Business Mailing Address:
APT. 403
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28216-2871
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-654-9106
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9325 LONG CREEK FAIRWAY DR
Provider Second Line Business Practice Location Address:
APT. 403
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28216-2871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-654-9106
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  8536 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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