Provider Demographics
NPI:1609275155
Name:GILJAHN, PAM
Entity Type:Individual
Prefix:MISS
First Name:PAM
Middle Name:
Last Name:GILJAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 BUENOS AIRES BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4053
Mailing Address - Country:US
Mailing Address - Phone:614-797-7150
Mailing Address - Fax:614-797-7151
Practice Address - Street 1:5757 BUENOS AIRES BLVD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4053
Practice Address - Country:US
Practice Address - Phone:614-797-7150
Practice Address - Fax:614-797-7151
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4458235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist