Provider Demographics
NPI:1013052141
Name:CHINNICI ANAMASI, JILL (MA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:CHINNICI ANAMASI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:CHINNICI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:11635 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4319
Mailing Address - Country:US
Mailing Address - Phone:216-231-8787
Mailing Address - Fax:
Practice Address - Street 1:29540 CENTER RIDGE RD STE B
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5115
Practice Address - Country:US
Practice Address - Phone:440-455-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00856231H00000X
OHA.02358231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist