Provider Demographics
NPI:1831922111
Name:HILLARD, JESSICA ERIN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ERIN
Last Name:HILLARD
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 1:415 1ST ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2481
Mailing Address - Country:US
Mailing Address - Phone:717-341-4615
Mailing Address - Fax:
Practice Address - Street 1:1015 GRAND ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2158
Practice Address - Country:US
Practice Address - Phone:717-341-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01285900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist