Provider Demographics
NPI:1396453411
Name:GELLINGER, SUSAN LEJANE (MS, CCC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEJANE
Last Name:GELLINGER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:LEJANE
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:211 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273
Mailing Address - Country:US
Mailing Address - Phone:903-815-8855
Mailing Address - Fax:
Practice Address - Street 1:100 W. PEACAN
Practice Address - Street 2:GRAYSON CO. SPECIAL EDUCATION COOP
Practice Address - City:GUNTER
Practice Address - State:TX
Practice Address - Zip Code:75058
Practice Address - Country:US
Practice Address - Phone:903-696-0015
Practice Address - Fax:903-696-0019
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11405235Z00000X
00069864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist