Provider Demographics
NPI:1831810829
Name:SCHILLER, GWENYTH (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:GWENYTH
Middle Name:
Last Name:SCHILLER
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 1:23 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1457
Mailing Address - Country:US
Mailing Address - Phone:847-507-2054
Mailing Address - Fax:
Practice Address - Street 1:11 CATTANO AVE APT 623
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6850
Practice Address - Country:US
Practice Address - Phone:847-507-2054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ14317735235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist