Provider Demographics
NPI:1346610128
Name:PALMER, GAIL (CC,C- SLP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:CC,C- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NE
Mailing Address - Zip Code:68446
Mailing Address - Country:US
Mailing Address - Phone:402-269-3405
Mailing Address - Fax:
Practice Address - Street 1:919 16TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305
Practice Address - Country:US
Practice Address - Phone:402-274-4354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE299235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist