Provider Demographics
NPI:1710601703
Name:CRANE, JILL SUSAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:SUSAN
Last Name:CRANE
Suffix:
Gender:F
Credentials:MS, 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 461407
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75046-1407
Mailing Address - Country:US
Mailing Address - Phone:972-487-3300
Mailing Address - Fax:
Practice Address - Street 1:7300 BLUEBONNET DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-6700
Practice Address - Country:US
Practice Address - Phone:972-475-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist