Individual
MRS. JILL DIAMOND GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2125 ELIZABETH AVE, LAURELDALE, PA 19605-2259
(610) 921-9292
Mailing address
2125 ELIZABETH AVE, LAURELDALE, PA 19605-2259
(610) 921-9292
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL000597L
PA
Other
Enumeration date
10/06/2008
Last updated
10/07/2008
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