| Doctor Name: | MISS CARLA JEAN GIGNILLIAT |
| NPI Number: | 1700084902 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CCC-SLP |
| License Number: | SLP005592 |
| Business Practice Address: | 1967 Lakeside Pkwy Suite 420 Tucker, GA - 300845867 |
| Business Phone Number: | 7704140055 |
| Business Fax Number: | 7704140045 |
| Mailing Address: | 1967 Lakeside Pkwy, Suite 420 TUCKER |
| State: | GA |
| Postal Code: | 300845867 |
| Phone Number: | 7704140055 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2007 |
| NPI Last Update Date: | 05/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP005592 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |