Individual
JILLIAN MICHELE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
645 BALTIMORE ANNAPOLIS BLVD STE 111, SEVERNA PARK, MD 21146-3956
(410) 544-2500
Mailing address
1176 ANNIS SQUAM HARBOUR, PASADENA, MD 21122-2554
(301) 509-3151
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
07855
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OSH815 53 1160
CARE FIRST BLUE CHOICE
MD
Enumeration date
03/31/2016
Last updated
03/31/2016
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