Provider Demographics
NPI:1912271362
Name:ROBINSON, JILL (MS)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13210 CAROLINE CT
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4064
Mailing Address - Country:US
Mailing Address - Phone:703-437-7897
Mailing Address - Fax:
Practice Address - Street 1:41680 MISS BESSIE DR
Practice Address - Street 2:SUITE 304
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2906
Practice Address - Country:US
Practice Address - Phone:301-672-2148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05430235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist