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Individual

AMANDA LYNN GILLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
133 OLD MILL DR, BOWLING GREEN, KY 42104-0831
(270) 348-0143
Mailing address
133 OLD MILL DR, BOWLING GREEN, KY 42104-0831
(270) 348-0143

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
08/23/2021
Last updated
08/23/2021
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