Provider Demographics
NPI:1467658906
Name:WILLIAMS, JILL ANDERSON (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANDERSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13925 88TH PL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-2305
Mailing Address - Country:US
Mailing Address - Phone:561-795-4460
Mailing Address - Fax:561-795-4460
Practice Address - Street 1:13925 88TH PL N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-2305
Practice Address - Country:US
Practice Address - Phone:561-795-4460
Practice Address - Fax:561-795-4460
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 2429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist