Doctor Name: | MRS. KASI M. GILLIS |
NPI Number: | 1730370982 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSE, CCC-SLP |
License Number: | 2966-154 |
Business Practice Address: | 204 W Warren St Roberts, WI - 540239617 |
Business Phone Number: | 7157493890 |
Business Fax Number: | 7157494081 |
Mailing Address: | 204 W Warren St, P.o. Box 220 ROBERTS |
State: | WI |
Postal Code: | 540239617 |
Phone Number: | 7157493890 |
Fax Number: | 7157494081 |
NPI Enumeration Date: | 08/05/2007 |
NPI Last Update Date: | 12/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2966-154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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 |