Provider Demographics
NPI:1871637215
Name:HEMMING, JILLIAN LEE (MS,CCC/L-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:LEE
Last Name:HEMMING
Suffix:
Gender:F
Credentials:MS,CCC/L-SLP
Other - Prefix:MISS
Other - First Name:JILLIAN
Other - Middle Name:LEE
Other - Last Name:THEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC/L-SLP
Mailing Address - Street 1:12145 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:YORKSHIRE
Mailing Address - State:NY
Mailing Address - Zip Code:14173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12145 COUNTYLINE RD.
Practice Address - Street 2:
Practice Address - City:YORKSHIRE
Practice Address - State:NY
Practice Address - Zip Code:14173-9800
Practice Address - Country:US
Practice Address - Phone:716-492-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017049235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist