Individual
JILLIAN RENEE TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3160 N ARIZONA AVE, CHANDLER, AZ 85225-7122
(480) 365-9981
Mailing address
2464 E LA COSTA PL, CHANDLER, AZ 85249-4190
(480) 486-6787
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA14548
AZ
235Z00000X
Speech-Language Pathologist
Primary
TSLP17617
AZ
Other
Enumeration date
08/07/2024
Last updated
07/28/2026
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