Individual
MS. KIMBERLY ANN GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
300 BELANGER DR, PEMBROKE, NH 03275-3258
(603) 485-9000
Mailing address
7 DEER MEADOW RD, CHICHESTER, NH 03258-6502
(603) 892-4271
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01106622
—
235Z00000X
Speech-Language Pathologist
1405
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01106622
AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION (ASHA)
—
01
—
1405
NEW HAMPSHIRE OFFICE OF LICENSED ALLIED HEALTH PROFESSIONALS
NH
Enumeration date
04/30/2020
Last updated
05/04/2020
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