Provider Demographics
NPI:1740026152
Name:ALUIN KEMP, GILLIAN MARIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:MARIE
Last Name:ALUIN KEMP
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2097 GALLATIN DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2354
Mailing Address - Country:US
Mailing Address - Phone:518-495-4330
Mailing Address - Fax:
Practice Address - Street 1:1805 PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-3923
Practice Address - Country:US
Practice Address - Phone:374-518-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist