Provider Demographics
NPI:1982754388
Name:BARTON, JILL ANDREA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANDREA
Last Name:BARTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 THOMAS TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-7822
Mailing Address - Country:US
Mailing Address - Phone:404-769-3308
Mailing Address - Fax:
Practice Address - Street 1:145 THOMAS TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-7822
Practice Address - Country:US
Practice Address - Phone:404-769-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist