Provider Demographics
NPI:1003397563
Name:ZWEIER, JILL BUTTWINICK
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:BUTTWINICK
Last Name:ZWEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 YARBERRY DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-1497
Mailing Address - Country:US
Mailing Address - Phone:707-953-6726
Mailing Address - Fax:
Practice Address - Street 1:101 MONROE ST
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2328
Practice Address - Country:US
Practice Address - Phone:707-763-4109
Practice Address - Fax:707-765-5714
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP6506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist