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Individual

MRS. JILL GRIFFIN BOULO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
166 MOBILE INFIRMARY BLVD, MOBILE, AL 36607
(251) 435-2016
(251) 435-3069
Mailing address
166 MOBILE INFIRMARY BLVD, MOBILE, AL 36607
(251) 435-2016
(251) 435-3069

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1835
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051525906
BCBS
AL
05
890012810
AL
Enumeration date
05/02/2006
Last updated
04/14/2014
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