Provider Demographics
NPI:1932778859
Name:BISKNER, JILL ANNE (LLMSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANNE
Last Name:BISKNER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MILITARY ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-5418
Mailing Address - Country:US
Mailing Address - Phone:810-984-5575
Mailing Address - Fax:810-984-6433
Practice Address - Street 1:1101 MILITARY ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5418
Practice Address - Country:US
Practice Address - Phone:810-984-5575
Practice Address - Fax:810-984-6433
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011103861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical