| Doctor Name: | MONICA GILLUM |
| NPI Number: | 1326397779 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 20542 Harper Ave Suite 109 Harper Woods, MI - 482251693 |
| Business Phone Number: | 3135713908 |
| Business Fax Number: | 3135713909 |
| Mailing Address: | 18601 Bainbridge Dr, SOUTHFIELD |
| State: | MI |
| Postal Code: | 480765312 |
| Phone Number: | 8109642359 |
| Fax Number: | |
| NPI Enumeration Date: | 08/30/2012 |
| NPI Last Update Date: | 04/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |