Dana Jo Gillman-Butcher

Individual provider Active NPI Speech-Language Pathologist · South Williamson, KY

NPI 1063594166 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1063594166
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3057 (KY)
Practice address
260 Hospital Dr
South Williamson, KY 41503-4072
Phone
(606) 237-1700
Fax
(606) 237-1701
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3057KYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3057 KY Yes

Addresses

Primary practice location

260 Hospital Dr
South Williamson, KY 41503-4072

Mailing address

260 Hospital Dr
South Williamson, KY 41503-4072
Phone (606) 237-1700

Other identifiers

IdentifierTypeStateIssuer
3057OtherKYKY BOARD OF SPEECH

Other providers in South Williamson, KY

All providers in South Williamson, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.