Provider Demographics
NPI:1851909402
Name:GILMAN, DESIREE MILLER (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:MILLER
Last Name:GILMAN
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 1:385 S HOLDAWAY RD
Mailing Address - Street 2:
Mailing Address - City:VINEYARD
Mailing Address - State:UT
Mailing Address - Zip Code:84059-2625
Mailing Address - Country:US
Mailing Address - Phone:801-380-1326
Mailing Address - Fax:
Practice Address - Street 1:4141 N S HERRERA WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1814
Practice Address - Country:US
Practice Address - Phone:602-248-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist