Individual
JILL SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E 34TH ST APT 1519, NEW YORK, NY 10016-9840
(716) 951-2764
Mailing address
222 E 34TH ST APT 1519, NEW YORK, NY 10016-9840
(716) 951-2764
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1767495231
NY
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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