Provider Demographics
NPI:1821611898
Name:GILLIGAN, MARGARET MARY (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARY
Last Name:GILLIGAN
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 1:17 MORNINGSIDE DR S
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5411
Mailing Address - Country:US
Mailing Address - Phone:203-313-9186
Mailing Address - Fax:
Practice Address - Street 1:12 WATERBURY LN
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4348
Practice Address - Country:US
Practice Address - Phone:203-313-9186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist