Provider Demographics
NPI:1932295870
Name:DONALDSON, GILLIAN (SPEECH/LANG PATH)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:SPEECH/LANG PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16836 FOUR SEASONS DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-3616
Mailing Address - Country:US
Mailing Address - Phone:703-680-6516
Mailing Address - Fax:
Practice Address - Street 1:600 JACKSON ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5719
Practice Address - Country:US
Practice Address - Phone:540-373-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202000592235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA036802OtherSENTARA
VA192571OtherANTHEM HEALTHKEEP PLUS
VA245465OtherMDIPA
VA4978145Medicaid