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General NPI Number Information
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NPI Number | 1528339538
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Entity Type | Individual
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Provider Name | TERRI LYNN GILL M.A., CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 620 E WATER ST
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City | DESHLER
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State | OH
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Zip | 43516-1327
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Country | US
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Telephone | 419-278-6921
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Fax | 419-278-2910
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Provider Business Mailing Address
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Address Line | 90 E BACK BAY RD
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City | BOWLING GREEN
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State | OH
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Zip | 43402-9228
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Country | US
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Telephone | 419-823-1080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-1991
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License Number State | OH
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