Provider Demographics
NPI:1437897162
Name:MATTHEWS, EILEEN GILL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:GILL
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:KATHERINE
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:303 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-8474
Mailing Address - Country:US
Mailing Address - Phone:603-244-0090
Mailing Address - Fax:
Practice Address - Street 1:118 RIDGEFIELD AVE
Practice Address - Street 2:
Practice Address - City:N TOPSAIL BEACH
Practice Address - State:NC
Practice Address - Zip Code:28460-5500
Practice Address - Country:US
Practice Address - Phone:603-244-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist