Provider Demographics
NPI:1053564716
Name:BRAV, GILAT (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:GILAT
Middle Name:
Last Name:BRAV
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 1:106 N CRABTREE KNLS
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5221
Mailing Address - Country:US
Mailing Address - Phone:919-768-7513
Mailing Address - Fax:
Practice Address - Street 1:1703 LEGION ROAD
Practice Address - Street 2:STE 204
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2371
Practice Address - Country:US
Practice Address - Phone:919-932-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6754235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist