Provider Demographics
NPI:1356879100
Name:GIGLIO, JACQUELYN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JACQUELYN
Middle Name:
Last Name:GIGLIO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:JACQUELYN
Other - Middle Name:
Other - Last Name:CHLEBOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:5000 VALLEY STREAM RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3554
Mailing Address - Country:US
Mailing Address - Phone:850-217-3187
Mailing Address - Fax:
Practice Address - Street 1:5000 VALLEY STREAM RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3554
Practice Address - Country:US
Practice Address - Phone:850-217-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8036235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist