Provider Demographics
NPI:1972207835
Name:MURPHY, JILLIAN MACKENZIE (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:MACKENZIE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 PEAT MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-4661
Mailing Address - Country:US
Mailing Address - Phone:203-232-8980
Mailing Address - Fax:
Practice Address - Street 1:469 W MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3400
Practice Address - Country:US
Practice Address - Phone:203-828-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist