Gignilliat, Carla Jean

Gignilliat, Carla Jean is an individual health care provider with primary practice located at 1967 Lakeside Pkwy Suite 420, Tucker GA 30084-5867. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Gignilliat, Carla Jean can be contacted via phone (770) 414-0055.

Contact Information

Primary practice address
1967 Lakeside Pkwy Suite 420 Tucker GA 30084-5867
Phone: (770) 414-0055
Fax: (770) 414-0045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005592 Georgia

Profile Details

NPI number 1700084902
LBN Legal business name Gignilliat, Carla Jean
Credentials MA, CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2007
Last updated May 12th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700084902 NPPES
Georgia MEDICAID 331791073B

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