Healthcare Provider Details

I. General information

NPI: 1093697732
Provider Name (Legal Business Name): GISELE JARAMILLO CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 COURT DR
GASTONIA NC
28054-1478
US

IV. Provider business mailing address

PO BOX 749
BELMONT NC
28012-0749
US

V. Phone/Fax

Practice location:
  • Phone: 704-824-4999
  • Fax: 704-824-3999
Mailing address:
  • Phone: 704-869-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30005356
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: