Provider Demographics
NPI:1053795591
Name:GILLESPIE, MONICA DAVIS (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DAVIS
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 SADDLEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061-9479
Mailing Address - Country:US
Mailing Address - Phone:803-767-4832
Mailing Address - Fax:
Practice Address - Street 1:640 SADDLEBROOK LN
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:SC
Practice Address - Zip Code:29061-9479
Practice Address - Country:US
Practice Address - Phone:803-673-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist