Doctor Name: | JILLIAN PAIGE PENLAND |
NPI Number: | 1134491681 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,CCC-SLP |
License Number: | 9590 |
Business Practice Address: | 5603 W Friendly Ave Ste B #274 Greensboro, NC - 274104252 |
Business Phone Number: | 3367900271 |
Business Fax Number: | 3367409099 |
Mailing Address: | 1523 New Garden Rd, Apt. 2e GREENSBORO |
State: | NC |
Postal Code: | 274101578 |
Phone Number: | 8283615864 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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 |