Provider Demographics
NPI:1780994038
Name:GILPATRICK, JEANNE G (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:G
Last Name:GILPATRICK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:EG
Other - Last Name:GILPATRICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11 EAGLE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-1043
Mailing Address - Country:US
Mailing Address - Phone:207-288-3631
Mailing Address - Fax:207-288-4706
Practice Address - Street 1:11 EAGLE LAKE RD
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1043
Practice Address - Country:US
Practice Address - Phone:207-288-3631
Practice Address - Fax:207-288-4706
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1049235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist