Individual
GILA ILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 COUNTY RD, TENAFLY, NJ 07670-1854
(201) 894-5800
Mailing address
7004 BOULEVARD E APT 5K, GUTTENBERG, NJ 07093-5005
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00922800
NJ
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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