Provider Demographics
NPI:1912041856
Name:SCHWARTZ, JILL MELISSA (MA, CCC -SLP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:MELISSA
Last Name:SCHWARTZ
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 1:650 WEST AVE APT 1806
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6364
Mailing Address - Country:US
Mailing Address - Phone:786-385-8160
Mailing Address - Fax:
Practice Address - Street 1:650 WEST AVE APT 1806
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6364
Practice Address - Country:US
Practice Address - Phone:786-385-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist