Individual
MRS. JANIS SUE GILLIAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2301 LAKESIDE DR, GREENWOOD, AR 72936-6105
(479) 996-6214
Mailing address
2301 LAKESIDE DR, GREENWOOD, AR 72936-6105
(479) 996-6214
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
950
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950
ABESLPA
AR
Enumeration date
06/20/2007
Last updated
07/09/2007
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