Healthcare Provider Details

I. General information

NPI: 1205760162
Provider Name (Legal Business Name): ROSEMARY GILLESPIE SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WOODWARD AVE
LOCK HAVEN PA
17745-1716
US

IV. Provider business mailing address

372 E WATER ST APT B
LOCK HAVEN PA
17745-1419
US

V. Phone/Fax

Practice location:
  • Phone: 570-748-1829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL016181
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: