Provider Demographics
NPI:1417326406
Name:COHN, JILL ALLISON (MS)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ALLISON
Last Name:COHN
Suffix:
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 1:9 BALFOUR DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-5252
Mailing Address - Country:US
Mailing Address - Phone:717-585-5075
Mailing Address - Fax:
Practice Address - Street 1:3700 VARTAN WAY
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9441
Practice Address - Country:US
Practice Address - Phone:717-585-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-19
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001532103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13550477Medicaid
PA13550477Medicaid