Individual
MISS CARLA JEAN GIGNILLIAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1967 LAKESIDE PKWY, SUITE 420, TUCKER, GA 30084-5867
(770) 414-0055
(770) 414-0045
Mailing address
1967 LAKESIDE PKWY, SUITE 420, TUCKER, GA 30084-5867
(770) 414-0055
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005592
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331791073B
—
GA
Enumeration date
07/10/2007
Last updated
05/12/2011
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