| Doctor Name: | WILLIAM MATT GILLISPIE |
| NPI Number: | 1609914720 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CCC-SPL |
| License Number: | 02157 |
| Business Practice Address: | 1200 Sunnyside Ave. 2101 Haworth Hall Lawrence, KS - 660450667 |
| Business Phone Number: | 7858644690 |
| Business Fax Number: | 7858645094 |
| Mailing Address: | 1200 Sunnyside Ave., 2101 Haworth Hall LAWRENCE |
| State: | KS |
| Postal Code: | 660450667 |
| Phone Number: | 7858644690 |
| Fax Number: | 7858645094 |
| NPI Enumeration Date: | 02/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 02157 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| 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 |