# MRS. JILL GRIFFIN BOULO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1235197146
- **Gender:** F
- **Credential:** O.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 1835 | AL | Yes |

## Other

- **Enumeration date:** 05/02/2006
- **Last updated:** 04/14/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 051525906 | BCBS | AL |
| 05 | — | 890012810 | — | AL |