Individual
JILL GRIFFIN-SOTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2888 CREST TER, EAGLEVILLE, PA 19403-4715
(239) 464-4978
Mailing address
2888 CREST TER, EAGLEVILLE, PA 19403-4715
(239) 464-4978
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SA8202
FL
235Z00000X
Speech-Language Pathologist
Primary
SL012340
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891099500
—
FL
01
—
SL012340
PA LICENSE
PA
Enumeration date
03/19/2007
Last updated
01/05/2021
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