Individual
JILLIAN HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
2017 S COLORADO ST, PHILADELPHIA, PA 19145-2911
(267) 664-9135
Mailing address
2017 S COLORADO ST, PHILADELPHIA, PA 19145-2911
(267) 664-9135
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SL013360
PA
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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