Provider Demographics
NPI:1073694675
Name:WARNER, JILLIAN SR (MS)
Entity Type:Individual
Prefix:MISS
First Name:JILLIAN
Middle Name:
Last Name:WARNER
Suffix:SR
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 HERTEL AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-2341
Mailing Address - Country:US
Mailing Address - Phone:716-831-1977
Mailing Address - Fax:716-831-1985
Practice Address - Street 1:699 HERTEL AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-2341
Practice Address - Country:US
Practice Address - Phone:716-831-1977
Practice Address - Fax:716-831-1985
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)