Provider Demographics
NPI:1558534073
Name:HIRSHBLOND, JILL A (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:A
Last Name:HIRSHBLOND
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:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:OCEAN GATE
Mailing Address - State:NJ
Mailing Address - Zip Code:08740-0264
Mailing Address - Country:US
Mailing Address - Phone:732-504-7872
Mailing Address - Fax:
Practice Address - Street 1:5 EVES DR
Practice Address - Street 2:SUITE 160
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3135
Practice Address - Country:US
Practice Address - Phone:856-985-9257
Practice Address - Fax:856-985-7943
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS000396500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist