Provider Demographics
NPI:1326896978
Name:GILLIAN, STEVIE JOANNA (CF-SLP)
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:JOANNA
Last Name:GILLIAN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BOLTON PL
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2169
Mailing Address - Country:US
Mailing Address - Phone:540-449-3602
Mailing Address - Fax:
Practice Address - Street 1:1900 HILLSMERE LN
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-1796
Practice Address - Country:US
Practice Address - Phone:540-885-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist