| Doctor Name: | JOHANNA GLENN GILLENWATER |
| NPI Number: | 1003216599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AU.D. |
| License Number: | A#354 |
| Business Practice Address: | 1 Childrens Way Little Rock, AR - 722023500 |
| Business Phone Number: | 5013644402 |
| Business Fax Number: | 5013646881 |
| Mailing Address: | 1 Childrens Way, LITTLE ROCK |
| State: | AR |
| Postal Code: | 722023500 |
| Phone Number: | 5013644402 |
| Fax Number: | 5013646881 |
| NPI Enumeration Date: | 09/03/2014 |
| NPI Last Update Date: | 09/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 231H00000X |
| License Number: | A#354 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Audiologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master |