Provider Demographics
NPI:1780856104
Name:GILMAN, KATHERINE (CCC/A)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:GILMAN
Suffix:
Gender:F
Credentials:CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1795
Mailing Address - Country:US
Mailing Address - Phone:856-848-0700
Mailing Address - Fax:856-848-6029
Practice Address - Street 1:620 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1795
Practice Address - Country:US
Practice Address - Phone:856-848-0700
Practice Address - Fax:856-848-6029
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00040700231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist