Provider Demographics
NPI:1780242073
Name:ROSOFF, JILL GRACE
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:GRACE
Last Name:ROSOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1828
Mailing Address - Country:US
Mailing Address - Phone:508-505-5368
Mailing Address - Fax:
Practice Address - Street 1:275 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-1467
Practice Address - Country:US
Practice Address - Phone:781-255-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist