Individual
JASON KILLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
1532 FAZIO DR, PINEHURST, NC 28374-1805
(619) 647-3507
Mailing address
1532 FAZIO DR, PINEHURST, NC 28374-1805
(619) 647-3507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15555
NC
235Z00000X
Speech-Language Pathologist
8442
LA
Other
Enumeration date
12/16/2021
Last updated
09/27/2024
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