Provider Demographics
NPI:1235890948
Name:STRMAC, JILLIAN ELIZABETH
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:ELIZABETH
Last Name:STRMAC
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 1:8221 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9786
Mailing Address - Country:US
Mailing Address - Phone:440-350-2563
Mailing Address - Fax:
Practice Address - Street 1:8221 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-9786
Practice Address - Country:US
Practice Address - Phone:440-350-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20201486-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist