Provider Demographics
NPI:1558991174
Name:GAMMILL, CAROLINE (SLPD, CCC-SLP, CBIS)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:GAMMILL
Suffix:
Gender:F
Credentials:SLPD, CCC-SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:256-318-5570
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:256-318-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist