Provider Demographics
NPI:1093341356
Name:BEBB, JILLIAN B (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:B
Last Name:BEBB
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N OAKDALE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3001
Mailing Address - Country:US
Mailing Address - Phone:785-452-6063
Mailing Address - Fax:785-452-6056
Practice Address - Street 1:155 N OAKDALE AVE STE 300
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3001
Practice Address - Country:US
Practice Address - Phone:785-452-6063
Practice Address - Fax:785-452-6056
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist