Healthcare Provider Details

I. General information

NPI: 1386574192
Provider Name (Legal Business Name): CHLOE GILMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W 3RD ST STE A
JOPLIN MO
64801-2512
US

IV. Provider business mailing address

223 W 3RD ST STE A
JOPLIN MO
64801-2512
US

V. Phone/Fax

Practice location:
  • Phone: 417-850-5437
  • Fax: 888-214-3770
Mailing address:
  • Phone: 417-850-5437
  • Fax: 888-214-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2026021943
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: