Provider Demographics
NPI:1134382450
Name:DILLARD, JENNIFER ANDERSON (MCD, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANDERSON
Last Name:DILLARD
Suffix:
Gender:F
Credentials:MCD, CCC-A
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:MICHELLE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD, CCC-A
Mailing Address - Street 1:1963 MEMORIAL PARKWAY SW
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-536-9300
Mailing Address - Fax:
Practice Address - Street 1:1963 MEMORIAL PARKWAY SW
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-536-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0929A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist