Provider Demographics
NPI:1558785717
Name:WILLIAMS, JILLIAN BROOKE (CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:BROOKE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 STEPHENSON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4347
Mailing Address - Country:US
Mailing Address - Phone:912-355-3372
Mailing Address - Fax:
Practice Address - Street 1:314 STEPHENSON AVE STE A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4347
Practice Address - Country:US
Practice Address - Phone:912-355-3372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist