Basic Information
| Provider Information | |||||||||
| NPI: | 1982160701 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIERL | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CFY-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1525 RIVER RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | RIVER FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540223462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6129873668 | ||||||||
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| Practice Location | |||||||||
| Address1: | 425 DAVIS ST | ||||||||
| Address2: | |||||||||
| City: | HAMMOND | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540159615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7157962218 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2019 | ||||||||
| LastUpdateDate: | 02/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 4781-154 | WI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.