Provider Demographics
NPI:1336456433
Name:DOCTOR, JILL CLAUDINE (MS, ED)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:CLAUDINE
Last Name:DOCTOR
Suffix:
Gender:F
Credentials:MS, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WOODCREEK LN
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1339
Mailing Address - Country:US
Mailing Address - Phone:716-773-5127
Mailing Address - Fax:
Practice Address - Street 1:295 CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-1126
Practice Address - Country:US
Practice Address - Phone:716-816-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant