Audrey Lynn Manalang Gillman, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-2808 Issued in NV

Practice address

9217 Brayden Bay St
Las Vegas, NV 89178-9311

Phone

(650) 564-4352

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amg Speech Therapy LLC

  • Speech-Language Pathologist
  • Las Vegas, NV
  • NPI 1194536490
  NPD Authorized official
• Ascend Pediatrics Inc.

  • Developmental Disabilities Clinic/Center
  • Union City, CA
  • NPI 1477498723
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1548735210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 BRAYDEN BAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891789311",
            "telephone_number": "661-645-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9217 BRAYDEN BAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891789311",
            "telephone_number": "650-564-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLMAN",
        "first_name": "AUDREY LYNN",
        "middle_name": "MANALANG",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "23578",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-2808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Gillins
• Bridgette Gillis
• David J Gillis
• Jasmine Gillis, QMHA
• Tiwana Gillispie
• Bryant David Gillman, BCBA
• Glen Ethan Gillman, BCBA
• Arnold O Gillo, LCSW
• Marjorie Valencia Gillo
• Amanda Sarah Gilman

• Speech-Language Pathologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Speech-Language Pathologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.