Provider Demographics
NPI:1538491956
Name:DILLASHAW, JILL TODD (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:TODD
Last Name:DILLASHAW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 W LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-7857
Mailing Address - Country:US
Mailing Address - Phone:469-424-1618
Mailing Address - Fax:
Practice Address - Street 1:1615 W LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-7857
Practice Address - Country:US
Practice Address - Phone:469-424-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional