Provider Demographics
NPI:1235227414
Name:TOWLES, GERALDINE MILAGROJA (MED CCCSLP)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:MILAGROJA
Last Name:TOWLES
Suffix:
Gender:F
Credentials:MED CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 ALLEN COURT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-391-0449
Mailing Address - Fax:
Practice Address - Street 1:4901 NOLENSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5411
Practice Address - Country:US
Practice Address - Phone:615-988-2340
Practice Address - Fax:615-988-2643
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNSP0000001550OtherSTATE LICENSE