| Doctor Name: | GENA S DISMUKE |
| NPI Number: | 1376780833 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC-SLP |
| License Number: | 845 |
| Business Practice Address: | 245 Cahaba Valley Pkwy Suite 200 Pelham, AL - 351242216 |
| Business Phone Number: | 2059426820 |
| Business Fax Number: | 2059425884 |
| Mailing Address: | 2639 Gilmer Ave, TALLASSEE |
| State: | AL |
| Postal Code: | 360787213 |
| Phone Number: | 3342833975 |
| Fax Number: | 3342528277 |
| NPI Enumeration Date: | 01/20/2009 |
| NPI Last Update Date: | 01/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| 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 |