Provider Demographics
NPI:1619250669
Name:MENSER, JILL RENEE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:RENEE
Last Name:MENSER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-2431
Mailing Address - Country:US
Mailing Address - Phone:270-253-3255
Mailing Address - Fax:
Practice Address - Street 1:309 GLENDALE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-2431
Practice Address - Country:US
Practice Address - Phone:270-253-3255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist