Individual
JILLIAN RENEE TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1313 E OSBORN RD, PHOENIX, AZ 85014-5678
(480) 787-5387
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
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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