Provider Demographics
NPI:1538507702
Name:HILLOCK, JESSICA LEIGH (MA CCC - SLP)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LEIGH
Last Name:HILLOCK
Suffix:
Gender:F
Credentials:MA CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1117
Mailing Address - Country:US
Mailing Address - Phone:317-501-7424
Mailing Address - Fax:
Practice Address - Street 1:525 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1117
Practice Address - Country:US
Practice Address - Phone:317-501-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46002453A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist