Doctor Name: | JILL MALISZEWSKI |
NPI Number: | 1114094661 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SA6455 |
Business Practice Address: | 12276 San Jose Blvd Ste 507 Jacksonville, FL - 322238618 |
Business Phone Number: | 9042888910 |
Business Fax Number: | 9042888912 |
Mailing Address: | 12276 San Jose Blvd Ste 507, JACKSONVILLE |
State: | FL |
Postal Code: | 322238618 |
Phone Number: | 9042888910 |
Fax Number: | 9042888912 |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 10/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA6455 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |