Provider Demographics
NPI:1205405149
Name:CAROLINE GAMMILL, NEURO SLP, LLC
Entity Type:Organization
Organization Name:CAROLINE GAMMILL, NEURO SLP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMMILL
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD, CCC-SLP, CBIS
Authorized Official - Phone:256-318-5570
Mailing Address - Street 1:3377 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-4088
Mailing Address - Country:US
Mailing Address - Phone:256-202-4151
Mailing Address - Fax:
Practice Address - Street 1:3377 LAKELAND DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-4088
Practice Address - Country:US
Practice Address - Phone:256-202-4151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech