Individual
MRS. JILL RENEE DETTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 DAVIS RD, OSSIAN, IN 46777-9352
(260) 622-7821
(260) 622-4370
Mailing address
0270W 1100N, OSSIAN, IN 46777
(260) 638-4664
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003241A
IN
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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