Provider Demographics
NPI:1679893051
Name:DENMAN, GABRIELLE ASHLEY (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:ASHLEY
Last Name:DENMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-2424
Mailing Address - Country:US
Mailing Address - Phone:731-445-2509
Mailing Address - Fax:
Practice Address - Street 1:1053 LOVERS LN UNIT B
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-7166
Practice Address - Country:US
Practice Address - Phone:270-467-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4118235Z00000X
KY267500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518439Medicaid