Provider Demographics
NPI:1407314172
Name:REIFFER, JILLENE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JILLENE
Middle Name:
Last Name:REIFFER
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 1:850 HUNGERFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1718
Mailing Address - Country:US
Mailing Address - Phone:240-740-5500
Mailing Address - Fax:
Practice Address - Street 1:18801 BARNESVILLE RD
Practice Address - Street 2:
Practice Address - City:DICKERSON
Practice Address - State:MD
Practice Address - Zip Code:20842-9738
Practice Address - Country:US
Practice Address - Phone:301-972-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05281235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist